Scottish Doctor, author, speaker, sceptic

What causes CVD part XL1 (Part forty-one)

Another slight detour I am afraid. This is due to the recent publication of the ORBITA study. Reported in the British Medical Journal (BMJ), thus:

‘Percutaneous coronary intervention (PCI) is not significantly better than a placebo procedure in improving exercise capacity or symptoms even in patients with severe coronary stenosis, research has found.1

The ORBITA study, published in the Lancet, is the first double blind randomised controlled trial to directly compare stenting with placebo in patients with stable angina who are receiving high quality drug treatment.’ Compared to the sham-controlled group:

PCI did not significantly improve exercise time. The numerical incremental increase in average exercise time was 16 seconds (P=0.20).

In short, PCI did nothing at all. I can hear cardiologists across the US putting plans for new swimming pools on hold. 2

As many people know, the purpose of a stent is to open up obstructed coronary arteries, and then keep them open, using a metal framework ‘stent’, that sits within the artery. This procedure has been done on thousands, millions, of people. In an acute myocardial infarction (MI or heart attack to you) it provides benefits. However, in non-acute blockage it does nothing, apart from enrich interventional cardiologists.

Frankly, I was surprised that these researchers got ethical approval for this study. Carrying out a sham operation is a pretty major thing to do to a patient. I am further surprised they managed to get any volunteers, but they did. I very much take my hat off to these researchers. Bold, very bold, indeed. They must have been pretty damned certain they were going to see no benefit from stents.

Anyway, this study only proves what many people had suspected for some time. Stents, in the non-acute situation, do not work. Of course, this study has already been attacked and dismissed. Here is one review from SouthWestern medical centre, entitled ‘Stents do work: A closer look at the ORBITA study data.’:

‘ORBITA was small – too small, in fact, considered definitive evidence that cardiologists should change the role of stents in clinical practice.

I participate in a number of cardiology care guidelines committees and even wrote a piece about the ORBITA trial for the American College of Cardiology. In order for regulating bodies to change clinical practices, research studies must present data from a much larger pool, such as the 2007 COURAGE PCI study, which enlisted more than 2,000 participants. In general, larger trials present data that are more statistically significant and more appropriate to apply to specific patient segments.’ 3

Too small? Wrong patient type, no doubt the wrong atmospheric pressure as well. Unlike the studies that were used when cardiologists first started doing stents, where the study size was precisely zero. In fact, if you read the entire article from the Southwestern medical centre, it is gibberish. But it will have the desired effect. The ORBITA study will have no impact stenting revenue. Like many other ideas in medicine, it is too seductive, and far too lucrative. The artery is blocked, it must be opened. End of.

Many years ago, Bernard Lown had precisely the same issue with Coronary Artery Bypass Grafting (CABG). Another massively lucrative intervention which rapidly became the operation – based on no evidence whatsoever. It was such an obviously brilliant idea that to question it was to defy ‘common sense.’ You have a blockage in an artery, bypass it with a graft.’

One thing that you find about good science is that it is usually very far removed from ‘pure common sense.’ It is counterintuitive. It is counterintuitive because it challenges established thinking a.k.a. prejudices. As Einstein had to say. ‘Common sense is nothing more than a deposit of prejudices laid down in the mind before age eighteen.’ He also said that ‘It is harder to crack prejudice than an atom.’

If you want a really good read, I recommend Bernard Lown [he is my hero]. He was the first to challenge the orthodoxy that CABG was an unquestioned good. For which he was of course, roundly attacked. His essay on this can be read here4. I include a particularly poignant section by Bernard Lown discussing CABG:

‘One might wonder why patients acquiesced to undergoing a painful and life-threatening procedure without the certainty of improving their life expectancy. I have long puzzled at such acquiescence. Surprisingly, patients not only agreed to the recommended intervention but commonly urged expediting it. Such conduct is compelled by ignorance as well as fear. Patients are readily overwhelmed by the mumbo-jumbo of medical jargon. Hearing something to the effect of “Your left anterior descending coronary artery is 75 percent occluded and the ejection fraction is 50 percent” is paralyzing. To the ordinary patient such findings threaten a heart attack or, worse, augur sudden cardiac death.

Cardiologists and cardiac surgeons frequently resort to frightening verbiage in summarizing angiographic findings. This no doubt compels unquestioning acceptance of the recommended procedure. Over the years I have heard several hundred expressions, such as: “You have a time bomb in your chest” and its variant “You are a walking time bomb.” Or, “This narrowed coronary is a widow maker.” And if patients wish to delay an intervention, a series of fear-mongering expressions hasten their resolve to proceed: “We must not lose any time by playing Hamlet.” Or, “You are living on borrowed time.” Or, “You are in luck — a slot is available on the operating schedule.” Maiming words can infantilize patients, so they regard doctors as parental figures to guide them to some safe harbour.’

The man is a genius and he can write far better than wot I can. I should hate him.

Some forty years later, or so, we find that CABG has been replaced by PCI/stenting. Exactly the same knuckle headed stupidity has driven stenting. The noise of sheep bleating ‘Narrow artery bad, open artery good,’ fills the air. My goodness, I think they’ve got it. Who could possibly argue with that? Kerching!

Those who have read my endless blog on the causes of on CVD will know I have long been highly sceptical of stenting as the answer to anything very much. Other than the removal of large sums of money from person A, to hospital B, and interventional cardiologist C.

Why does it not work? How can it possibly not work?

Because the heart is not simply a pump, arteries are not simply pipes, and humans are not inanimate objects whereby our function, or lack thereof, is purely dependant on some form of medical or surgical intervention. Thus endeth the lesson on stenting.

“It was such an obviously brilliant idea that to question it was to defy ‘common sense.’”

Even a very brief and superficial acquaintance with the history of science clearly reveals this to be true of most of the really wrong ideas that held up progress for years. Just as it was obvious that, if arteries were getting blocked, the process must be “just like when a drain gets clogged with fat”.

Thank you for this ‘layby’. When stenting is used for a genuine MI, how long do the stents last, usually, is it known? Do they tend to block up again? Is it known if a change of diet would help to prevent stents re-blocking, or don’t we know? I have a friend in this situation, only in his fifties. Would be grateful for any light shed…

Thank you for the reply. I suppose seven years is better than instant death in one’s fifties. Does nature’s own bypass system work with blocked stents, in which case the seven or so years should give new blood vessels a chance?

Paul, the Head Honcho of the American Heart Association just had a heart attack at age 52 and “fixed” with a stent… If he was taking preventative statins, I don’t see them as doing him any good! Or, for that matter any of the advice the AHA has been giving us ! I think we’re Doomed.
With ORBITA out of the bag, no point in us having preventative stenting so we may as well invoke the acronyms….. EDTA, DIET, EECP LIFESTYLE, etc

When questioned a cardiologist recently replied that CABG can restenose in 8 years. Assumed that this was the case when a patient follows the cardiologist’s recommendations i.e. avoid saturated fat and take statins.

In an acute MI. Otherwise, not a chance. However, I fully understand the pressures on everyone to ‘do something.’ It is the single most powerful driver of human behaviour, and human stupidity. My own philosophy is ‘don’t just do something, stand there.’

Since my CABG x 5 a year ago, I’ve – already – come to the same position. In my opinion, I was cunningly conned into agreement, by having my Wife present when he made his ‘Sales Pitch’. NO alternative was canvassed, even in the the negative. – So much for the “Informed” part of “Consent” …
– Editing my current… Opinions… will keep me out of the Legal System!!!

My experience is five years or less. This is the case with my husbands heart problems… Another things is that often the stent is not long enough, so other stents have to be placed alongside the first one…

At the rate I’m “progressing”, another 6 years to re-stenosis would be a bonus!
After a year post CABG x5. (elective / stable angina) my exercise tolerance is no better than before…No other therapy was offered at the time or since. One can be forgiven for wondering if CABG is merely the up-market version of the PCI as exposed by ORBITA !

Heresy of the highest order – we are supposed to take the efficacy of PCI, and many other interventions on faith alone. Medicine is becoming an all powerful corporate religion. Ironic, as the powers that be insist that their beliefs come from gold standard research. Smoke and mirrors.

Yes. I am always amused to see conventional medicine condemn functional medicine because it leads patients astray from “evidence-based medicine”. Except that the evidence is generally pretty thin or nonexistent. I can’t comment on what works best for CVD-related conditions, as I have no current experience from myself or family members. But, when Dr. Lown says that “Maiming words can infantilize patients”, I’ve seen it happen to friends and family in so many areas of medicine — cancer, diabetes, intestinal issues, mental illness, etc. It’s SOP as a tactic to get folks on statins, too.

“Paul, the Head Honcho of the American Heart Association just had a heart attack at age 52 and “fixed” with a stent… If he was taking preventative statins, I don’t see them as doing him any good! Or, for that matter any of the advice the AHA has been giving us ! I think we’re Doomed.”

No, obviously he was not yet taking enough statins or cutting out enough (saturated) fat. What other explanation could there possibly be?

Gandhi was once asked what he thought about Western civilisation

“I think it would be a very good idea”

I feel the same about “evidence-based” medicine, most of it is actually dumbed down one-size-fits-all dogma-based medicine, or as I have seen it described, marketing-based marketing.

You can just about get away with writing off one patient’s experience as an “anecdote” but when the number of identical anecdotes reaches critical mass, and far outnumbers the subjects of studies (especially when they are actually genetically modified mice) only a blinkered idiot would continue to ignore them.

Manipulation is the one behavior I won’t tolerate in a doctor. I mean, he has to give me the details even if I don’t understand them. Those details belong to me as much as the money for doing it belongs to him. Too often it’s the nurse who attempts to force cooperation during ignorance. Questions like “What are all my options?” or “Are those my only options?” will either scare a doctor into bluster, or forge a trusting relationship with me. Another good one is, “You’re requesting my permission to do something to my body. In order to do so, you must tell me exactly what you will do, why, and why now. Or I’m leaving.” I used that when I got my gallbladder out. Until I said that, I wasn’t told it was infected, just a bunch of people looking surprised an shaking their heads. Well I don’t give permission based on ominous silence and shaking of heads. In a way I feel sorry for some doctors. The internet has held their feet to the fire more than anything in history. The genie is out of the bottle, and the three wishes are being awarded to the patients.

You and me -both!
I feel totally bulldozed into agreeing to a multi- CABG, the cardio cunningly making sure my Wife was present and suitably aware (frightened?) of my inevitable doom. At no time did he mention any options such as Optimal Medication Therapy, do nothing, or EECP, the last I suspect as dangerous to his income! – Not even to explain why they were not appropriate or efficacious. Science (proof) based therapy withstands robust questions, blind dogma does not.

Frederica, in case you mis ed the news,,, PCI for Stable angina (elective procedure, not emergency…) has after 40 years, just been proven a sham, no better than the placebo-effect of a fake procedure. Very Embarrasing to say the least, which casts a pall over the value of CABG when applied as a “better option” for the same reason.
With CABG x 5, for the above, you can imagine that I’m not well-pleased at the prospect !

Most people have collaterals, whether active or dormant. Everyone has vasa vasora, feeding vessels too large to take nutrients/oxygen from the stream of blood they carry. If you remove a stenosed or occluded coronary you must also rip out by their roots its attending vasa vasora and collaterals. So, CABG destroys the body’s own method of dealing.

How many CABG cases are prepared for by examining the status of these tiny vessels?

How are these tiny potential life savers effected by stenting of the larger vessel they serve? Squashed flat perhaps??

“The man is a genius and he can write far better than wot I can. I should hate him”.

May I respectfully submit that you write very well indeed, and with an element of dry humour that is most welcome. When explaining technical matters, moreover, a relatively plain writing style has much to recommend it. In his book “How to Enjoy Writing”, Isaac Asimov uses the metaphor of a stained glass window for literary writing, and of a perfectly transparent plate glass window for technical explanations. The reader should be aware of the subject matter, and not even notice the language that is used to convey it. For my money, Asimov is right on the money.

George Polya offers another rather nice piece of advice in his classic book “How to Solve It”:

“The first rule of style is to have something to say. The second rule of style is to control yourself when, by chance, you have two things to say; say the first one, then the other, not both at the same time”.

Agreed, the Bernard Lown piece is excellent and I have bookmarked his blog.

Malcolm too, it goes without saying.

It’s good to see an increasing number of medics in the Real World questioning orthodoxy although it often takes time and some bravery, like my current GP, and the vascular surgeon who was prepared to stent me (different situation, PAD in my legs, and strangely much worse in one leg than the other) but said he would rather see what I could do for myself first by generating collateral circulation by walking through the pain, which worked so well he took me off his list without earning a penny from me, well from procedures anyway. I ever so slightly think he had seen this happen before – sadly so many doctors refuse to notice OUTCOMES when they go against The Rules. I suspect the death of PCTs may have something to do with this relaxed attitude. Would be good to see NICE go the same way – a great idea ruined by ideology (and profits).

Reading between the lines and the comments on this and another of Mandrola’s articles it looks like although stents don’t work for most patients, for some they do. Perhaps it would be a plan to look for differences between these patients?

When you go back far enough, like Gerald Reaven among others, you see data presented as graphs of individual patient responses. Often you see a bunch of similar responses but with differing amplitudes, then a few which zing off in different directions.

Almost certainly in most “modern” studies such outliers would be eliminated, then the rest would be amalgamated into a mush using clever statistics.

With two glass of a very good organic wine now in my chest at a nice restaurant after having been exposed to a range of wonderfully flowering orchis in the greenhouse of the botanical garden i really feel how my parasympathetic system thrives.

Goran,
That sounds so good!
I can understand you not wanting to drink the poisons intended to protect the grapes, but organic wines do not have the nitrites and nitrates added to conventional wines.
There is an interplay among nitrates, nitrates, and nitric oxide in our bodies that I certainly will not pretend to understand!http://ajcn.nutrition.org/content/90/1/1.full
I’m just wondering if you’re missing a chance to increase your NO by drinking organic.
Are you up on this?
Anyone?

JDPatten: Thank you for that link. A good article concerning nitrates in food. Do not worry about them (the DASH diet contains a whopping 550% of the WHO guidelines for dietary nitrates, yet is considered a very healthful diet by some). Do you remember the nitrate scare in the ’90’s? They stopped using it to cure bacon, substituting celery powder, which is very high in nitrates. Now the bacon actually has more nitrates than before! Funny as hell. In honor of your reminding us of paying attention to our NO, I picked a very fat celery stalk this afternoon for my garden salad for supper, with which I will have sablefish, goat brie, raspberries, nuts, and 100% chocolate. A meal fit for a king eaten by a mere peon.

JDPatten: I get it from Vital Choice Wild Seafoods, based in the State of Washington. Sourced from Alaskan fisheries, which, under their state constitution, must be managed sustainably (and likely is cleaner than many parts of our oceans). The founder is Randy Hartnell, a former fisherman. I heard him speak, then met, and had a long conversation with him. He’s a good man whom I trust completely. I think they ship nationwide, and everything always comes fully frozen. I order a three-month supply (about $500-$600 worth) four times a year, and salmon and sablefish (so wonderfully fatty!) are my favorites. I also love the smoked salmon and Ikura caviar (which looks the same as fish bait!). And the tiny shrimp (from Oregon) are great in salads.

I guess that our bodies are very advanced self sustaining chemical labs. Myself I don’t interfere more than necessary and with “natural” substances that make sense to me. Wine does in moderate amounts.

Because PCI/stenting is doing nothing to address the underlying pathological etiology. Indeed, it’s probably aggravating matters because the hapless victim is now also going to be subject to more fervid dietary dogma (of the sort that enabled the disease), and perhaps chronic meds (that further distort microbiome).

Once I had a car whose brakes needed relining early. Next service they needed relining AGAIN. Third time this happened, a different garage took a better look and identified a hydraulic problem leaving the brakes permanently semi-engaged. When that was fixed the brake life reverted to what was expected. Obviously they employed proper engineers rather than just part-swappers.

I asked Larry in the comments on his article dealing with this about the alternative to stenting that might actually work — EECP. (Enhanced External CounterPulsation: discussed here several days ago.)
His answer was not encouraging at all.

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Hi Gary . . . Just couldn’t ignore FFR, oh how I tried . . . and as luck would have it I came across a nice piece on Fractional Flow Reserve . . .http://www.ptca.org/ivus/FFR.html

Rather than using an angiogram to see what fraction of blockage there is in an artery . . . and sort of guess the reduction in blood flow it must be causing . . . the FFR measures the actual flow rate/ pressure through the blockage. A reduction of 0.75 (3/4?) => stent.

Antony,
We should rely on you to look stuff up for us, yeah? 🙂
“. . . through the blockage.” Does that mean from before the arterial blockage to the distal side were the artery is still patent, taking into account possible collaterals and vasa vasora that might be bridging?

Is Larry considered to be part of The Establishment or a Fellow Traveller ?
If so, don’t hold your breath for any form of acceptance of a therapy that threatens a portion of the Cardio-Surgeon’s natural prey…
I wish I’d been informed of EECP (or EDTA chelation) before I was ‘shepherded’ into CABG x 5.

I was treating acute myocardial infarctions in the ER 40 years ago. Diagnosis was based on history and physical, confirmed by ECG (yes, we missed a few). Treatment was oxygen, IV morphine, sublingual nitro, with the crash cart parked next to your bed. This was a 600 bed hospital, and not one board certified cardiologist on staff. I recall starting b blockers in the ER the following year, ASA was still years away. Clot busters a decade away, and nobody thought about stents or emergency CABG procedures. Most important: nobody asked WHY? It was “WHAT?” What was the diagnosis? What is the drug? Later, it was what was the procedure? Today, the same institution has more cardiologists than I can count. And only now are we doing RCT on PCI? We are much better at sorting out “what”, but still fall short on the “why”. I left the ER early on, with the goal of preventing that visit in the first place. Then, and now, still asking “why”.

A friend was not told she was diabetic until after she had had her first heart attack. She subsequently discovered that she had FAILED a glucose tolerance test in childhood. Well she recalled that she was put on a low carb diet for a while but neither she nor her parents were told why, or that it was anything other than a temporary intervention.This was long before diseases came to be seen as drug deficiencies (or obesity as a surgery deficiency). IMO a clear case of the “why?” not being addressed – if it was perhaps the future could have been avoided.

That GTT only confirms that the patient has been diabetic for YEARS. A Kraft insulin pattern would have warned her over 10 years prior. Low carb diet was the right starting point, pity they didn’t fully understand the rest of the equation !

Depends on the type IMO, like me she obviously had a broken Phase 1 response all her life but unlike me her Phase 2 eventually deteriorated to the point of diagnosis (mine only got to severe prediabetes).

I agree that both of us, and many others, could have benefited most from the unavailable Insulin Assay

If you follow a diet that keeps the level of insulin in the body to modest levels then coronary vascular disease then the likelihood of blockages is greatly reduced. To this end I go for the low carb/high fat/moderate protein diet . . . it works for me and my 80 year old uncle (both T2D reversers)

When you are metabolically trapped it goes without saying that a ketogenic state should be the best way to get out of that trap. To me there is overwhelmingly strong scientific support for such an attitude even if it is not so very easy to adhere to the strict LCHF diet necessary. (Today, e.g., at the nice restaurant in the botanic garden I cheated with a piece of bread 🙂 )

I have just bought a new “toy”, apart from my standard blood glucose testing device, and it is a ketone meter measuring the level of ketones in the blood. It works by analyzing the air when exhaling. Compared with standard testing the blood with test sticks, where each stick carry a hefty prize tag, each test with this “toy” is free while the unit itself is about 200 – 300 USD.

The ORBITAL study confirms what I have learnt from the contributors of this blog . . . for the sort of heart condition I had (have?) there was no need for a stent . . . Let the collaterals do their job.

Dr. Kendrick: Thank you for this. CardioBrief had some posts on ORBITA, but I couldn’t make a whole lot of sense of them. It deserves plain language. And thank you for the words of Dr. Lown. He is a hero to all of us who know of his work. I agree with Tom: Your writing is mighty good!

I often wonder how many lives you have prolonged due to your easy-to-read, intuitive and straight-to-the-point writings, that certainly have helped me personally as well as my patients, with this article in-particular, helping to confirm that I definitely made the right choices regarding my own CVD.
Back in 2015 – the week after I had climbed Ben Nevis – I was told by a heart consultant that I had had at least two Heart Attacks, and that my heart showed a significant plaque burden in my LAD (Severe – almost total), RCA (critical) and circumflex (moderate) coronary arteries, and that I needed stents and statins straight away.
When I stopped laughing (the consultant was not amused), I told him where to stick his stents and statins. Trying to convince me, He went on to say that my condition was a widow maker blah blah.. still chuckling I left his office.
I was only able to make this informed decision, due to your earlier writings pointing to the work of Bernard Low, who’s work opened my eyes to the theory of a collateral coronary blood supply. So thank you Dr Kendrick for all your continued work and musings.

…Based on my experience in intensive care last year with an ejection fraction of 20% (“in the act of dying” as Peter Langsjoen referred to one of his patients in one of his CoQ10 talks) I came around with a stent already inserted and signed on the dotted line without hesitation to have a device implanted in my chest.

What did I know about all this, especially being a 1st timer? What state are you in anyway to make these decisions – weak, stressed out, confused for starters.

But surely there may be some merit in stenting as a quick fix in life threatening situations?

Long term – how do you unblock?

I had this thrown back at me in trying to get an CT-CAC scan on the NHS (which my GP refused). Why bother – what will you do if you have a high calcium score (and blocked arteries).

Presumably all this means there is no medication to unblock and stenting, as this post discusses, is the lucrative, mainstream fix.

I paid for my own CAC scan, wanting to get the cardiologist off my back with a good score. After all, I had no CVD symptoms at all, just slightly elevated total cholesterol. Came back the highest CAC he’d ever seen, giving me a “Preexisting Condition” that I’d never actually experienced.
I think that there are likely other conditions than CVD plaquing that result in calcification.
Still, I summarily quit atorvastatin after a miserable three months. Doing fine.

JDPatten: Seems to me what they are saying is there are hardly any trials on this. What they don’t say is that there probably won’t be many since EDTA isn’t patentable. Or is it? What about the mouse fat melter?

JDPatten: How true. I recently received a mailing from the “group” my doctor belongs to (why they have these groups escapes me; probably has to do with insurance, as these doctors practice all over the county, which is larger than several countries). The mailing invited me to come in for “free!!!!” testing, likely of those indicators which are the bread and butter for intervention cardiologists. I put it in the recycling bin.

By subjecting yourself to their tests you are “lured” into their “treatment traps” which brings yuo further away from the idea that you really could “heal” yourself and basically on your own. Measuring your ketone levels apart from blood glucose can though be great since it is always good to objectively confirm that you are on the right track to “healing”.

It would of course be superb if you really could get some support from the NHS but there seems to be very little to find “out there” if you are not able to find a rare unorthodox GP who are truly, like Dr. Bernard Lown or Dr. Kendrick, on your side. Conventionally “trapped” GPs will probably feel threatened when you with good reasons reject what they suggest and advocate alternatives This is quite a natural human reaction when ones “expertise” is being challenged, easy to imagine, and I have certainly experienced that myself. NHS rather brings you down into a mire.

As far as I now understand this that goes with most (all?) of our chronic diseases; CVD, diabetes, cancer, psychic disorders, arthritis ….

This is why you should “keep away” and find out what to do on your own!

A couple of years ago I read a book on this subject with the proper title “OVERDIAGNOSED” . This book is stressing your point.

Same here. CAC- score was never-ever mentioned by either of my otherwise excellent GPs, or the cardio. Found it by surfing Youtube / Ivor Cummins – The Fat Emperor.
Shrt story, while I was in Bali having EECP and EBOO therapies, I arranged a scan. $470 including the local Cardiologist. Not cheap, but useful as a Benchmark.. (870, if you are curious)
Agree, if,and a big IF I’d ignored the Dr’s Orders to report immediately to a cath lab on the strength of a sky-high ‘Troponin’ test.
My hindsight is impeccable….

James,
Mine: 1,640.
The cardiology group that I was seeing didn’t pester me with PCI since I had no symptoms at all. They did, however, press atorvastatin on me so hard that I folded. For three miserable months. They were reasonable to the extent that, when they finally accepted my ultimate refusal of statin, PCSK9 inhibitors, fibrates, etc, they also accepted that drawing blood for cholesterol testing had no point. And, to my surprise, they’re fine with me monitoring my own blood pressure and titrating my own med accordingly. (I think, possibly, they’re waiting for me to show up in the ER!)

Yes, because it directly sees the calcium then measures what it’s looking at. Almost “mechanical”.
Think of a long ship. A depth sounder is fitted you know not where, middle or either end. Nor how properly it’s aimed… straight down is ideal, but if aimed off-vertical will falsley show more depth… But using a CAC weight on a line dropped over the side… can only go straight down…and the distance marks on the line tells depth,- and you know where you are (ends or middle) .on the ship…
But the Sounder has a sexy screen and coloured lights….

Hmm, 50% you say? Even an Engineer would move on and root around for a more valid ’cause’ ….(!) sorry, too good to pass up…
Which invites stress/strain back onto the playing field, – with muted murmurings from Macclesfield.

I was dismayed to read that your GP did not see the point in the CT-CAC scan. A fair number of this blog’s subscribers would see the root cause of metabolic syndrome problems (CVD T2D etc.) as being insulin resistance/hyperinsulinemia . . . . (Must learn to type “root cause” without using an Irish accent – sorry Ivor) . . . . And many think that the way to deal with this is lifestyle change (diet and judicious exercise) . . .

But you need to have some way of checking that you are succeeding, heading in the right direction. “If it don’t get measured, it don’t get fixed”. A straight forward, obvious example is to give a T2D person a glucometer. This certainly helped me keep on track. Then there was the infrequent HbA1c – more help in setting goals. Found the TG/HDL ratio was the wrong side of 1.0 . . . OK more drastic carb cutting. And finally, there are the bathroom scales to check the weight is not creeping up . . . time for a few 22hr fasts.

After a cardiac episode I had a stent fitted (low to medium blockage in ONE coronary artery). Four years on I now wonder how do I stand with respect to heart health. Is my present lifestyle conducive to reasonable heart health? Are any atheroma stable ones? How reliant am I on collaterals?

If the doctor does not see that it is possible to influence heart health by lifestyle change then he might well look at the CT-CAC procedure and say “What is the point?” But the point is that the result will tell you if you are on track or if you need to tweak. Used in this way the CT-CAC scan can be used as an arm of preventive medicine . . . saving money in the long run.

I would dearly like a relation of mine to get a CT-CAC scan. I suspect it would be life changing.

Antony,
The medical profession, and cardiologists in particular just love screening tests. It gives them a reason to intervene. If you take those CAC results back to him, he’ll most likely tell you that you must first take on medical intervention. Translation: Statins. What a statin will do for your calcifications is INCREASE them. The rationale is that this renewed artery hardening “stabilizes” the otherwise vulnerable plaque. Besides, as he will also likely tell you, you can’t reduce your calcification burden. All you can do is slow its inevitable progression. I’m having none of it . . . until RCTs such as the one under discussion here clearly show benefit.

CAC when properly employed by a Shamanistic Doctor is a brilliant motivator, and it ….. Wait a bit, if the patient mends his evil ways he won’t need my expensive surgeries! What was I thinking? Forget about CAC, it won’t tell you what I want you to hear…..

Political commentator, Tim Russert, a few years ago: a coronary calcium score of 550 that his doctor dismissed as nonsense, treating his cholesterol with a statin and hypertension with various agents, along with aspirin, advising a low-fat diet and exercise. Five years later, Mr. Russert died suddenly on the set of his Meet the Press TV show. If we calculate his heart scan score at the time of death, it was 1880, a score that is associated with 15-20% per year death or heart attack: Mr. Russert’s heart attack and death was clearly written on the wall 5 years earlier, but an ignorant colleague failed to see it. Mr. Russert should be alive today, healthy, not having submitted to any coronary procedure.

From my point of view . . . 4 years ago I was told I had a CAC of 600 . . . No-one seemed concerned. 4 years on having followed what I hope has been a dietary straight and narrow I would love to know what the present CAC score is. Have I been treading water? (ok) or have Ilowered it (yippee!) or if it is creeping up (need more stringent interventions . . . up the vitamin K2 ?)

Just found this from Dr. Davis . . . a rather muddled “lets throw everything at the problem” sort of study. . . which showed that “surprisingly” CAC scores can be reversed . . . I am sure he has better later studies.

Hmm. One size does not fit all.After the first MI’s 21 years ago, the central artery was totally blocked. CABG x 3. The central graft re-blocked immediately. 10 months of complaining about angina (take this nice beta blocker, it will fix it – did it, bu””ge”y) LIMA. Still running free in 2013.
2013 2 MI’s in a circumflex artery – stent.running well as far as I can tell.
It gave me pause this summer when Rick Parfitt died – he was scraped off his kichen floor and CABG’d while I was hustling about the angina that needed sorting . I must be getting something right.

Far too much technical writing is needlessly obscure. It would be wonderful if papers were given a K score by reviewers, and those that scored below K4 (out of a range from K1 to K10) were sent back to be re-written!

A friend recently told me that she’d had a stent fitted a few months ago. She told me that she was lucky to be alive as the artery was 90% blocked and she could have had a heart attack at any minute. She now suffers from dizziness which may or may not be connected or just maybe down to whatever meds she now has to take with at least one (probably an anticoagulant) for life.

I resisted the urge to tell her that she probably didn’t benefit from the stenting. What’s the point?
And the cardiologists who recommended her treatment were, I’m sure, totally convinced in the advice they gave.

From Dr K’s writings I’m beginning to think that most cardiologists are joint equal to most nutritionists in the quality of the advice / recommendations they give. The thing is you can always quite easily change your diet. A bit more difficult to reverse a cardiological intervention.

Well I guess that understanding has to start with the fact (at least according to the latest study) on average, this treatment did not good! Who knows exactly why – I suppose they need a more sophisticated model of what happens in these situations – but surely medical treatment shouldn’t be used if it doesn’t in fact benefit anyone!

David: Read the FFR article Antony linked to. I think it must be true that a major blockage with good flow is because the collaterals have taken up the slack and if this is the case, few, if any, symptoms?) Still an invasive procedure to find out, but much less so than a stent.

Jimmy . . . have a look at the video showing how the heart can deal with a blockage (stenosis).
. . . . http://heartattacknew.com/heart-catheter-film/
The blockage in the video is clearly a lot greater than 90%.
When any cells begin to suffer from lack of oxygen they send out signals that stimulate the growth of new blood vessels. In the above coronary case, because of a blockage that has slowly developed over time, some heart cells will have registered a drop in oxygen . . . their chemical ‘distress’ signals stimulate new blood vessel growth.
The new blood vessels mentioned in the film the narrator calls collaterals.

As we have learned from your past posts, this was probably due to the collateral arteries. As I have learned from my investigations, These are fully formed in about 25%, and partially available in about 75% of patients. Interesting that they would not take into account the obvious pathology of the “circle of willis” OR the obvious fully functioning human in front of them with 90% closed off main arteries as proof that something else is working to bring blood to the associated pathology. Thanks again for pointing us in this direction and increaseing my knowledge base.

Another great affect/effect:

Pretty much all mainstream medicine is based on the placebo affect. The placebo effect is around 2%, so anything with less than 2% improvement or effectiveness, and I would argue it should be more than 10% to be effective, falls into being part of, or less than the placebo effect. here is the list of placebo effect medicine:

Stents
Statins
Many Vaccines
90-95% of all Chemotherapy
Anything with an NTN >100

I mentioned previously that the carving up of the normal distribution curve for human cholesterol level, and setting the target less than the average was heresy. as such, anything that is less effective than the placebo effect essentially falls into the mathematical/statistical liar column as well.

Maybe another way to explain this is that many of these approaches do not go after the root cause or “etiology” in medical terms. So any medical intervention that does not address root cause, should be used only in the short term to stabelize, then addressed with further testing to determine root cause and remedy per result.

There is one more MAJOR medical effect, the Semmelweis effect! This one is the doctor who proved the etiology for the higher death rates of child bearing women and infants in hospitals in the mid 1800’s was due to cleanliness, (hand washing). he was thrown out of medicine for exposing the obvious crime.

Placebo: It seems to me that the point of RCTs is to eliminate the obfuscation of placebo and the newly coined nocebo effects. Except, of course, when those are the primary research targets.
I must say that if any physician comes at me with the intent of treating through placebo, he’s fired.

JDP, the context is important : If you were invited to be part of a research trial that was investigating your health problem, I think you would accept.

And then you would be randomly assigned to either the trial group,or placebo group with neither you or the trial knowing which who was in either. That is the reason why they are called double blind trials.

Of course you could decline that invitation. That is your right. But doing so because you do not want to be part of the placebo group, would I suggest be churlish.

I was speaking of the placebo EFFECT being used as treatment. Was that not clear?
I’ve had doctors use euphemisms on me. It’s often a choice of acronyms or baby talk. I’ve had to ask series of questions to get through layers of obfuscation and still reach a wall. Doctors use jargon among themselves and have generally lost the ability to talk to people in a straightforward way. As a matter of fact, I think it’s that jargon that keeps many in the blind rut of the antiquated protocols that we argue against here. For too many doctors, I suspect, to fit comfortably into the medical heirarchy, pride is the carrot and shame is the stick.
For the sake my own state state of mind, and therefore my health (see blog entry # XL) I choose straightforward honesty in my relations with anyone, but especially those effecting my physical and mental well-being.
Is the intentional use of “the placebo effect” a practice of dishonesty? Well, yes, inherently. Conscious, subconscious, or unconscious – it’s there. Call it pretense if you want. Dissembling. Artifice. It’s all the same. Don’t mess with me, doc.

Some research suggests that even if you know you’re being plied with placebo effect, it still works. That might be interesting to look at.

Then JDP, if such is your view,fine. You choose to exercise your right to not be part of the trial. But fortunately in the ORBITA trial others decided differently and now some important new information about stenting has been put to the public eye.

The alternative would be willfully remaining ignorant which can hardly be a useful or beneficial thing.

JDP, I ‘m glad we are not diagreeing…. Jusy mis-undertanding each other
🙂
You might find this book informative. Surgery, The Ultimate Placebo by Ian Harris. New South Press 2016. Ian Harris is an orthopaedic surgeon in Sydney.

I am reminded of my own experience back in 1997 when I ruptured an ACL in my knee. The orthopaedic surgeon did an arthroscopy to ‘confirm’ the ACL rupture. it was already evident on screen so the op was pure placebo and no doubt good for his wallet. But he declined to do the ACL operation. Thought I was too old. Nasty young bugger !

Orthopedic surgeons? Ugh. Do I have stories.
The one having to do with placebo, sort of: I took my elbow to the specialist. Steroid injection for chronic tennis (More like masonry hammer!) elbow. Back in a month and a half of failure. During that period I learned what a bad idea steroids are. Instead he offered injecting Platelet Rich Plasma, which had been all over the news at the time. He confided in me with a wink that the jab of the needle without PRP was just as effective. Now they call it “needling”.
I declined. Fine now, having laid off the hammer for a while.
How’s your ACL now?

JDP RE My ACL.. A couple of years later here in South Australia, I fell off a ladder ( due to the ruptured ACL ) Went ^& saw the GP about it and he said let’s reconstruct that ACL.. And within a month I was on surgery. It’s not 100% ( maybe 90% ) but when I asked the surgeon said ” You have old tendons, ( at 54 )they stretch a bit..Ummm

Bill,
Dr Lown mentions Faith. I should think that what the patient has faith in could matter, but not necessarily. Is it faith in the knowledge, skill, and beneficence of the all-powerful overlord? (Doctor!) … or faith in one’s own capacity to observe, analyze, and come to conclusions using one’s own effort at THOUGHT.
I submit that most people here have little faith in doctors’ capacities to bring about timely thoughtful resolutions.
What does the placebo effect depend on?
Anecdote: Faith in the general surgeon’s mechanical skill at removing a necrotic appendix? I had little choice in the ER, but it paid off. It all worked as it should. But, as I’ve told before, it set off a nasty episode of paroxysmal atrial fibrillation. I knew, at the time, that a sufficiency of magnesium is required for normal rhythm, so, when the attending cardiologist (Not my choice!) came to my room “threatening” a digoxin infusion if the situation didn’t resolve (Digitalis can kill in this situation!), I sent my son on a seventy mile round-trip to get my magnesium tablets at home. I was desperate! Imagine my relief when my savior returned. I happily crunched down my handful of cure. Relief! Sounds like an excellent set-up for placebo, yes? Well, I got more and more discouraged as the rhythm didn’t resolve over another day and a half. It finally ended in normal sinus rhythm and I went home … and looked up magnesium in greater depth. Turns out that cellular magnesium is what makes the difference for rhythm, and it takes months of elevated intake and elevated blood level to make a cellular difference. My (mistaken) complete faith in my own “cure” failed miserably as a placebo. Physical reality prevailed. The episode took its usual paroxysmal course.
I think all the harder about such stuff now. I’m the only one I can depend on when it comes down to the crux. Doctors are hired consultants and advisors, sometimes collaborators. It depends.

This is all fantastic information. My brother had a stent inserted, and is also on a statin, and it seems to me that many patients are bullied, in a sense, into operations and drug use. If they dare to question, they are threatened with dire consequences.

Speaking of heros, after just finishing Doctoring Data, the most interesting and eye opening book I have ever read, Dr. Kendrick is my new hero (my dog trainer hero will have to move over). I can never go back to my old way of thinking….good thing! Thank you Dr. Kendrick!

I had to laugh today at the statement a commenter made on another blog (mainstream news mag article on health), “Clinical trials are not doctored!” Of course, I had to jump in and provide links to articles by Ioannidis (“Evidence-Based Medicine Has Been Hijacked”) and Marcia Angell (formerly of NEJM). I think I got those originally from one of Dr. K’s articles. I’d like to think that the person making the indignant remark in defense of conventional medicine was a person that may have been medically browbeaten and brainwashed at some point in the past, and thus may be able to recover. If the person reads the references and responds, I’ll answer by suggesting that he/she read Dr. K’s book as a next step. But, I suppose it’s also possible that he/she was a pharma troll….

A milestone has been reached, forty one ‘whacks’ at ‘The Question’, – shades of Lizzy Borden !
Don’t stresss, your writing is fine, maybe a tad Scottish… (economical…) but cutting through the rhubarb nicely.
The reference to Dr Bernard Lown is pure gold, well worth printing out and reading at leisure.
Despite a CABG x 5 last year, I cannot shake the feeling that I’m no better off than before. Indeed, EECP in June did me a (GP observed) ‘Power of Good; !

I wish I’d known this before my husband was given 5 by-passes at age 90. He was never any good healthwise afterwards. He’d had well-controlled angina for 25 years previously. After the CABG he was in intensive care for 6 weeks. He was lucky to survive.

I think the answer to this might depend on what contribution you think various factors have on the blockage and whether you are willing to believe the claims that some doctors have unblocked or reduced the blockage of arteries via diet. If you believe that they have and your diet was pretty poor then the alternative would surely be to refuse the stent and go down the radical diet/lifestyle change. The problem is all people who get a stent are advised about having one, in very strong terms, whilst lying on an op table. There is no ‘go way find out a bit of information and have a think about this’. So of course most frightened, uninformed people say yes, stick the stent in please and save my life.

smartersig: Watch, or read Dr. Mercola’s interview with Dr. Kate Rheaume-Bleue. Lots of good information. By the way, I love pomegranates! They are grown around here, commonly as ornamentals, but also commercially. We used to steal them as children, we loved them so much.

This is nothing new though. Majority ofnevidence suggests pci lacks benefit in stable artery disease. However, dont forget one crucial fact: they spent 6 weeks with three phonecalls from a cardiologist per week to do intensive risk factor optimzation with drugs before enrolling patients. In other words, they maximized drug treatment during 6 weeks prior to PCI/placebo and almost 40 patients were fully relieved from angina during those weeks!!! U got to love these evidence based drugs like beta blockers, statins, Ace inhibitors etc.

I participate in a trial with maximum dose statin and have witnessed my coronary plaque volume reduce by almost 30% over 1.5 years. Im completelt free from angina now. But one must still confess that it would have been bettter to öove healthy from the start in order to avoid the entire problem.

I can understand the desire to push this in countries like America where healthcare is privately funded but cant quiet understand why the NHS would be happy wasting millions on unnecessary operations out of a already suffering budget. What’s the incentive for them ?

There are many drivers of behaviour, other than money. You would think this evidence would mean that the use of PCI in stable angina should stop – saving this NHS many hundreds of millions of pounds every year. I will predict that there will be small blip, then everything will return to normal. Although on a small scale, every so often, evidence comes out to show that wearing face masks in surgical operations achieved nothing for infection control. All surgeons still wear face masks. This has nothing to do with money. There are a whole series of complex emotional reasons why surgeons like wearing face masks. Status, power, and suchlike. A similar psychological dynamic as to why bishops like wearing silly hats, or the queen has a crown.

Surgeons in face-masks reminds me of the robes, – yes ‘robes’ (and Funny Hats) worn by Doctors in a recently viewed episode of … Star Trek.
For the bored among us, ever noticed how midday TV Gab- show doctors are invariably dressed in Operating Room ‘scrubs’ ? – Makes for good ‘Theatre’, one may say and it illuminates more about their motivators than they’d be comfortable with !

Our Aussie ‘Medicare’, or NHS analogue, is equally keen to fund stents and CABGs – at the expense of EECP. No private health fund here will pay anything towards EECP for the simple reason that ‘Medicare’ does not recognize & support it. And Medicare is advised by…. Yep, highly paid Medical Specialists. . . . . Join the dots!
Even with a ‘success’ rate of “only” 20% for stable angina patients, the savings from not butchering ‘stable’ patients would be huge. – Maybe even enough to pay for more MRI’s in regional public hospitals and… – oh, hang on a bit! – Fewer elective procedures done = reduced profits for Private hospitals… and Cardio-Surgeons…and Path labs..
Methinks the Tax Department may wish to express their…. ‘interest’.

My brother in law died a few days after stenting, he had stable angina. You know,he lost his beautiful, vociferous, tortoishell cat, which followed him everywhere, like a dog, just before this procedure. I often think because of the heartache he felt, his condition worsened.
Yes science based medicine is important, but when someone is so hurting inside, well, there are consequences. No doubt his TB as a teenager played a part, and other health problems.
Dr Kendrick is very holistic and looks at the wider picture, but his time is of course NHS frantic.

Sylvia, I hear, and feel your pain. You would appreciate the book Human Heart-Cosmic Heart, in which Dr Cowan addresses these issues. I have no doubt that my emotional state was the driver into CABGs a year later… Appropriate post op support would have eliminated the stress from the brain surgery consequences. And it would have been so much cheaper for all !

From Bill In Oz
November 13, 2017 at 5:38 am
Thanks Randal for these links again. They are a day’s work to take them all in.But I notice that Magnolia bark is used mainly for easing stress and getting a good sleep..

Bill in Oz: Nevertheless, it is possible with Camellias. I think, though, you’re smart to listen to your lady. This is why I have roses. I like them (in someone else’s garden), but I hate thorny plants with a passion!

One thing bothers me about this Orbita report so please put me right if I have missed something. Did the placebo group receive the same level of drug administration as the other group and can we rely on the effect being the same. I ask because when you get a stent and go on the meds your cardio function is shot when it comes to exercise. Probably exaggerating a bit but it does decrease. Mine bombed despite radical diet change resulting in 35 lbs being shed

I have to admit on the subject of plaque progression, which has cropped up on this entry, I have not looked much at Pycnogenol. Has anyone used it and can comment on effects side or otherwise. This study suggests potential

“The reason veins and the normal pulmonary artery do not develop atherosclerosis may be due to the fact that the transmural flux of solute (as described by Darcy’s Law) is diminished due to the low venous and pulmonary artery lumen pressures. In addition, with these lumen pressures generally being lower than the pressure within the arterial vasa vasorum, these vasa vasorum may never be compressed during the entire cardiac cycle, thereby maintaining adequate flow in the vasa vasorum. Nonetheless, the need for a high density of external vasa vasorum in vein walls is likely due to the fact that the venous (unlike arterial) blood in the main lumen provides little, if any, oxygen to the wall via transendothelial diffusion from the main lumen.”

I don’t know if you like that answer, Dr Kendrick. ??

The articles does tend to corroborate my idea, albeit indirectly, that stents would squash flat adventitial vessels. Vasa vasora (Is that plural or not?!) are subject to compression under varying pressure conditions.

Sorry I am not in the admonishment business, but yes, I do like pointing out problems with any issue and I tend to focus on the technically most difficult as that is where I have made my mark.

So here is the latest, sorry for the long post but you REALLY need to see the bottom and let me know what you think!

Disruption of Sympathetic Nervous system Google Search and report:

http://ajpheart.physiology.org/content/278/2/H515
Our findings suggest that in subjects with SCI (Spinal cord Injury), the loss of sympathetic vasomotor tone contributes more than inactivity to reductions in venous vascular function. Heightened VC, VOt, vasomotor tone, and venous compliance in the active group compared with the sedentary group imply that regular endurance training contributes to optimal venous vascular function and peripheral autonomic integrity.
Wow, regular exercise is the best antidote to poor motor function. Reinforces Dr. K’s inputs on SCI patients having higher cardio-vascular issues.
How the sympathetic and Parasympathetic systems work in balance, or if dysfunctional, not work together called dysautonomia.http://www.holistichelp.net/dysautonomia-autonomic-nervous-system-dysfunction.html
Pretty good basic explanation of how it all works together, what we can do to help, etc. Warning: No scientific papers referenced here, but one physiology textbook.https://www.sciencedaily.com/releases/2017/09/170919102530.htm
An interconnection between the nervous and immune system: Researchers have shown that the increased incidence of infections seen in spinal cord injury patients is directly linked to a disruption of the normal central nervous system.

Abnormal cardiac function associated with sympathetic nervous system hyperactivity in mice
“Our results demonstrate that chronic elevation of sympathetic tone can lead to abnormal cardiac function in the absence of prior myocardial injury or genetically induced alterations in myocardial structural or functional proteins. These mice provide a physiologically relevant animal model for investigating the role of the sympathetic nervous system in the development and progression of heart failure.
The development of end-stage heart failure often involves an initial insult to the myocardium that reduces cardiac output and leads to a compensatory increase in sympathetic nervous system activity. There is a growing body of evidence that, while beneficial acutely, chronic exposure of the heart to elevated levels of catecholamines released from sympathetic nerve terminals and the adrenal gland may lead to further pathological changes in the heart, resulting in a continued elevation of sympathetic tone and a progressive deterioration in cardiac function”
So their hypothesis is that cardiac issues begin a cascading problem involving the SNS, which leads to progressive deterioration. So which comes first, the SNS issue or the Cardiac issue?

“The severity of these arrhythmias was shown to be dose dependent; thus, as the concentration of catechol-amines increases, the chance of experiencing lethal ventricular fibril-lation increases (49). Prolonged stimulation of α-adrenergic receptors may also result in coronary spasms resulting in myocardial ischemia and functional hypoxia, which may cause many of the underlying etiologies of SCD (1).
prolonged activa-tion of the sympathetic stress mechanism can have detrimental effects including ventricular remodelling and enhanced arrhythmogenesis
Pretty good paper on a lot of SNS issues, big picture and focused efforts with some remedies.”
Several other papers tying autonomic nervous system disorders to Stroke!

Coronary Issues on the top of the list for this one
So are coronary issues the initiator or the follower of the SNS disruption? Does the SNS initiate this via its dysfunction, high stress events?
However, I am also seeing a similar thread along with all the other cardio vascular variables, it seems that almost every single one of these can be helped by EXERCISE and optimized or reduced by minimizing GLUCOSE/INSULIN levels!

Then I stumbled onto this short book, which lays out the theory of Heart Attack via no coronary issues.

I LOVE this Dedication: To our critics and those we have criticized.
I’ll have to use that in my next technical paper!
They cover collaterals and they think that collateral circulation does not increase via biogenesis, we are born with it, but increases in size due to disease states: The casts also indicate that in three circumstances homo- and intercoronary collateral vessels increase in size, namely in cardiac hypertrophy, in chronic hypoxic diseases with normal coronary arteries and in the presence of critical coronary stenoses. Only in atrophic hearts with normal coronary arteries are the diameters of collaterals less than normal (they call enlarged collaterals normal?)

Their conclusions on page 7+ you have to read several times to comprehend it and I will try and boil it down, but I suggest taking a look yourself. The Collaterals compensate for problems along the way, sometimes they find damage to heart muscles (5% in mild cases and 68% in severe cases of collateral usage), But these people did not die from heart attack. So basically the body has a built in vascular system redundancy in the heart and brain which you have from birth. In most cases this system works to provide flow around severe restrictions or completely shut off arteries. It responds by enlarging and increasing the flow volume, etc., but seems to be only when needed.
Another point in their conclusions is that stenosis that had been opened up reverted in hours or days!
Let’s try on a new theory for collaterals: ( I will go out on a limb on this one with pure logic and try to take it farther than I have seen so far)
Collaterals have evolved to help humans live longer
Collaterals are available from Birth
Collaterals are redundant backup vasculature
Collaterals are different for everyone, some biologic dependencies and genetics are at work.
Opening up occlusions in many patients did nothing to help, they revert back quickly
Total occlusions are found in healthy people, most of the people dying of different causes at advanced ages have occlusions.
As we age, collaterals are more likely to be used. The collaterals are there for a reason….that reason must be that clogged arteries are EXPECTED and a NORMAL state of human ageing.
Because of all the reasons above…. Clogged arteries are a NORMAL state and not abnormal at all! In fact our bodies have planned to have clogged arteries with collaterals that can take on 3-5x the flow required and it probably does not matter much how we get there, because there are numerous routes that tend to increase with ageing and wear and tear no matter what we do!!!
Ageing, Hormones, Diet, non-Exercise, smoking, pollution, High BP, etc., etc., etc.

Collaterals have evolved as a vascular redundant backup system to support clogged and damaged arteries from normal ageing and wear and tear! Because clogged arteries are a NORMAL state, any intervention of clogged arteries is superfluous and compete failure of the basic understanding of biologic and evolutionary sciences. That’s why when studied, stents are of no value. Statins are of no value, anything involved with trying to keep clogging arteries from clogging does not matter because clogging arteries do not by themselves cause MI. So the collaterals provide us with the logical key to unlock many mysteries and straighten out the scientific understanding of our condition.
I’ll have to keep reading and studying this paper. The other papers above have some interconnecting features and backup the Baroldi Book.

Steve,
A lot of interesting and challenging stuff put forward here.
I have trouble with “…clogged arteries are EXPECTED and a NORMAL state of human ageing”.
Whose expectation?
When thinking in terms of “normal” and “aging”, I like to know what evolutionary concepts are being invoked. The classic theory has evolution hinged on what can be passed on. Beyond the age of procreation, not much can be contributed.

Perhaps collateral circulation redundancy is not specially reserved for the aged!? How might procreating Youth benefit? I can imagine ancient cultures thriving on the wisdom of their aged, thereby indirectly contributing to our current make-up. (Flight of fancy.)

So if I am looking for Root Cause, I find that heart attack victims have occlusions. then I look at everyone else and I find they all have occlusions. Maybe I can take it further that occlusions in certain areas cause more damage or something like that, but if I find that occlusions are confined to certain areas (which they are, probably due to pressure or flow restrictions or rough fluid dynamics) and everyone has them, So I would then logically conclude that occlusions are normal, this is not a major root cause, so move on to investigate other root causes. we have a wealth of information in this area, we also know that trying to change occlusions via mechanical and chemical means has been proven to fail, and fail very quickly in many instances. So we have pretty much everything we need to know. everyone has occlusions, fixing occlusions does not work. this is not root cause for cardiac failure. Maybe it is a still a minor cause?

There are several other systems to look at during our root cause investigation. Electrical, chemical, mechanical. Obviously, this is not some simple single variable issue, I expect to find a major root cause or two, and a few minor ones, maybe some extra minor instigators.

But at least we now have eliminated occlusions as a major root cause. We can still look at why occlusions happen, how to optimize this condition, but it is not going to be a large contributor to heart attacks because everyone has occlusions, but only 20% of the population dies from attacks or variations of attacks.

So I am digging deeper on the collaterals, based on the science we have today, a similar system in the brain, the circle of Willis, is fully functional in only 25% of patients/ 50% are partial functional and 25% are dysfunctional. do these dysfunctional get most of the strokes?

It may be similar in the heart. How many people have fully functional, vs partial or dysfunctional coronary collaterals? This is a harder one to answer as it is a far more complex system and hard to measure a moving object or unused collateral system.

If this proves out, then dysfunctional collaterals explains a high percentage of heart attack deaths along with occlusions as the instigator. Then Maybe this is the major root cause. It may be measured and then effective medicine applied to improve the situation, reducing HA deaths near zero. treat only dysfunctional collateral patients, save billions with the most cost effective solution. Then go after cancer, diabetes, etc.

So based on the logic and experimental results we should move on to other areas than just occlusions. I am not saying that we have found root cause, we have eliminated occlusions as the main root cause! the cause that has been focused on by medicine for the last 50 years! Time to look at others. We need to look at things differently, 40,000 foot views, microscopic views, forwards and backwards, always applying logic and experiments to measure our progress.

My take-home is… All and anything that supports and encourages collaterals is to be preferred, such as exercise regimes, supplements and lifestyle. Restrict invasive interventions to Disaster Salvage, where the harm is already ‘done’ . eg the head of the AHA receiving a stent for his MCI on Monday – during a meeting!

So, will he recognize that his problem indicates that all their blather about the saintliness of PUFAs, the evils of sat fats, the horrors of coconut oil, etc., now are suspect? That is, assuming he really believed the party line and was following the recommendations, instead of being a closet junk-food junkie.

annielaurie: Yes, I wonder how many of these folks believe and follow the crap they peddle! I met a young Israeli couple on the trail this summer, both biologists. He told me that, in Israel, physicians have the lowest compliance rate for the flu shot of any group. I suspect the same is true here. Proctor and Gamble bought the AHA long ago, and other benevolent charities have joined in the fun since. Is he still eating his Crisco, swilling his Pepsi? Doubt he’ll fess up to it. Perhaps we can expect a book at some point.

And a thought that has been lingering in the back of my mind.Could inserting stents inhibit the development or functioning of collateral arteries ?

Stents are fundamentally coiled metal wires. After being put in place in an artery, I assume that the coiling is meant to prevent the artery blocking again. But perhaps metal is also pressing and blocking the collaterals. I have read somewhere that collaterals do not show up in CT scans.

One might wonder why we need proto-collaterals when the body has the ability to create new blood vessels via angiogenesis, something that cancerous tumours exploit to feed themselves.

But of course tumours grow slowly. In the case of an artery blockage, angiogenesis might not be fast enough to save oxygen-starved tissue.

We know that arteries self-seal when cut, for instance when the body is injured, but if they do so it means the tissues they serve are getting starved of blood. A new blood supply is needed urgently. If collaterals are available “off the shelf” as it were, they could be opened up and bring in emergency blood, even if poorly distributed, and leave it to angiogenesis to restore fully-functioning supply over time.

So it makes sense to have two blood supply systems, nascent collaterals for quick but crude supply, and angiogenesis for finely-tuned and balanced supply.

As an aside, I went to the Body Worlds exhibition of plastinated bodies some years ago. It was fascinating to me just how dense the network of blood vessels was.

Which poses the question: What is the optimum density of blood vessels? The denser the network is, the better cells can be supplied with oxygen and nutrients, and presumably the quicker, faster, and stronger the body is. But on the other hand, the denser the network, the faster blood is lost if injured, and more resources need to be devoted to repairing and maintaining the blood supply and delivery system. i guess it’s all been sorted out via evolutionary trial and error.

Steve
I find this very interesting, the notion that we perhaps have self-repairing circulatory systems. Anecdotally, I was having a scan around the caryatid artery and the radiologist found a collateral going upwards. She claimed never to have seen such a thing before! The question that interests me is whether they start growing because they might be needed or do do we all have little bypasses ready to be opened up when needed?

I get plenty of arthritis, back pain and stuff but never go to the GP with it and I avoid all pain- killers. I find it all gets better eventually or resolves pretty well over time, awful though it can be. A horrid shoulder took some years but feels pretty normal now and has done for years. My extreme carpel tunnel got better without any help – eventually. My chronic sacroiliac joint dysfunction has recently started to improve….. I know it’s not always the case and some people need hip and knee replacements and maybe I’ll need one myself one day but people do rush for help, don’t they?

Now two friends have similar joint issues but go down the route of operations whenever they’re available and pain-killers which have brought on anxiety and panic attacks.

I feel sorry for GPs. All that training and then generally being expected to go against their better judgement.

I appreciate what you tell us and my bottom line of approach to health today is the importance of actually not ruining your immune system, e.g. by carbs and/or vegetable oils.

Sometimes you though need to take a remedy as I did a year ago being struck by a nasty pneumonia. Clear cut antibiotics!

Talking about horrid shoulders I had a really nasty one about ten years ago and when my wife finally forced me to see a GP for testing for suspected Lyme disease she turned out to be right. Again antibiotics worked wonder. Since I had carried this sore shoulder for such a long time this disease had turned chronic although there is no such thing according to official dogmas about Lyme disease. Looking for openminded GP’s I found one oppositional Lyme group in the US and had then another antibiotic treat for a very long time and my shoulder I was then truly cured – my now “splendid” shoulder tells me.

Yes, I think it is important not to get completely negative about mainstream medicine. It represents one of humanities greatest achievements. It is mainly in the area of nutrition, CVD ‘prevention’, metabolic disorders etc. that is has gone horribly wrong.

There doesn’t seem to be anything nowadays that cant be treated (or at the very least seriously improved) by removing carbs from the diet and increasing on healthy fats (bye bye Veggie Oil). T2D is fuelled by carbs, Cancer feeds off sugar etc. The more I read about the subject, the overwhelming benefits of a low carb, high fat, moderate protein diet is the way forward. And yet despite all of the evidence that I come across, the food and drug industry along with Nice and the NHS are still banging on about low fat foods. Clearly they are all happy to see unhealthy people buying their products. And now I have just read how baby milk is rammed full of sugar to get them hooked from near to birth.
It actually disgusts me how these people have infected the system which should be there to protect us.

Memorable quote:
““This study will shake things up,” predicted Dr. J. F Michael Gaziano, a professor of medicine at Harvard who was not involved with the study. He anticipated that it would have the same effect on people’s thinking about blood pressure as studies of about lowering cholesterol levels did when they showed that, contrary to what many had thought, the lower the number the better.”

NNT of 92? That’s not high, but if the had 14 deaths per 1000 in the 140 group and 10 per 1000 in the 120 group, isn’t that an NNT of 250?

Significance was only found in those with a starting RR of < =132. So does that mean these folks were not treated at all if assigned to the 140 group? In that case, maybe the attention lavished upon those in the 120 group was enough to make a difference? Or some of the BP lowering drugs have a beneficial effect when given in very low doses?

Adverse effects were massive.

Is this study really the main study that supports the new guidelines? And the European Society of Cardiology is seriously thinking about following suit?

Eric: Thanks for the link. Zoe Harcombe nails it. SPRINT is essentially worthless for guiding anyone’s decision about whether or not to take BP drugs. I’ll stick with Sidney Port’s analysis of the Framingham data.

Beth
QuoteThe new definition will result in nearly half of the U.S. adult population (46 percent) having high blood pressure, with the greatest impact expected among younger people. Additionally, the prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45, the guideline authors note. However, only a small increase is expected in the number of adults requiring antihypertensive medication. Unquote
Sounds good for business. Would love to know what the recommenders think they are doing? So 46% of adult Americans are hypertensive. Seems unlikely to me.

Yes, I’m still digging, but I find it interesting that while the authors have few “official” conflicts of interest with pharmaceutical companies that make anti-hypertensives, they have a fair number with companies that make diabetic medications. The new standards would recommend treatment for any diabetic with a BP of 130/80. There are currently over 100 million Americans with diabetes or prediabetes. I fully expect to see a scandal a few years down the road about how these drug manufacturers colluded in some way. What I haven’t been able to uncover is how much pharmaceutical company money is going to the universities and medical centers these authors work for. Who, me – cynical?

ANAHEIM — The president of the American Heart Association, John Warner, MD, 52, had a “mild heart attack” on Monday morning, according to the AHA. Warner received a stent at an undisclosed hospital. The AHA said he is “doing well.”

Was he on the AHA recommended low fat diet? or a reaction to the ORBIT study.

The chairman did not have the heart attack. I doubt that these people are closet junkies as such. The chairman of these companies can afford not to eat the crap they are peddling and usually have the education to appreciate whats actually in them. These people see CEO or chair jobs as independant of the moral stance of the industry, even to the extent that they will move from one apposing industry to another when switching jobs. We currently have the chair of the British Horse Racing Authority head hunted from the chair of Ladbrokes bookmakers, Fox and chicken coops spring to mind

How does everyone view this latest announcement, that is the president of the AHA has a heart attack at 52. I mean there are at least a couple of ways of looking at this. The first being the politically correct response of well its all genetic or random and the guys just unlucky, it could happen to anyone or the less politically correct reaction of would you be happy if the president of the campaign against drink driving has just been found intoxicated behind the wheel. Assuming that he has blocked arteries judging from the stent I would be in the latter camp. If a cardio and president of the AHA cannot keep himself off the op table for heart disease by 52 then I would suggest he is either barking up the wrong tree or is a do as I say not as I do merchant. As a footnote I have just watched a video interview of both him and the chair and neither look poster boys for excellent health and weight. At the very least the AHA must be concerned that they appointed him.

Personally I make nothing much of it. Just as when James Fixx, the great promoter of running for health, died of an MI, aged 52, whilst out for a run. You can do things to change the odds, but you are never going to get the risk down to zero. I am just glad to have dodged the bullet so far – what, with my cholesterol level of 7.5mmol/l. [I will only crow about it, when I get past eighty].

Fixx like many runners of that era and probably the current era ate a very high carb diet. Lots of high glycemic stuff like pasta, bread and the like in the belief that carb loading as it was known was the way to go for runners. Couple that with sheer stress on the vessels that we have discussed it comes as no surprise that we do not read about the incredible longevity of distance runners, and I am a runner who now only does short interval running as opposed to distance stuff.

I’d go with the Dr Joseph Kraft approach… check insulin Response, chart the results over hours..and draw the obvious conclusion. He could have had decades of advance warning instead of learning the Hard Way, – to be sure…
Other logical explanations might be:-
(a) Despite knowing his Familial CVD, he chose to either do little or nothing in medication management. Stubborn, non-compliant patient… Proof being the Event !
(b) IF he was on cholesterol meds, then they – again obviously – do not work.
(c) Cholesterol is not a Root Cause, rather a ‘result’ of another underlying dysfunction, so “beating it into submission” is meaningless.. Or dangerous.
(d) Diet. We are all curious if he supports AHA / Low Fat eating, or t’other side?
(e) The Gods on Mt Olympus are having sport, deflating the AHA in particular, and Cardio’s in general…
– The last has a certain appeal…

The diet hypothesis is being tested every day with the sifting of numerous variables and it is always very confounding. nearly always resulting in a J-curve against death from all causes which indicates too little or too much seems to be the consistent result for everything.

Our liver, kidneys, etc can perform wonderfully for a long time then they just get overloaded on one thing and they stop, Sometimes this is a long process, sometimes this is instantaneous, like a heart attack. So should we maybe be looking more at faster processes? would this eliminate a lot of the superfluous variables? Is this a similar process to diabetes, where a switch is turned on and fat storage stops and glucose elevation in the blood is a result?

Look at percentages and normal distributions. How many affected, how effective is the treatment, these tell you if the etiology is correct.
In HA, the treatments are not working! or working so little they are hard to measure and even small improvements on the order of 1% are heralded as significant. This is the textbook definition of insanity.

So the body’s ability to heal itself is a given with enough time and effort
Too much of most things are bad
Too little of most things are also bad
You would have to measure the capacity of the body for eliminating/healing each type of issue, find out the normal distribution for each and advise accordingly. A painfully long and expensive path for sure, we don’t have the time. Any other ideas?

A big question, Is it even possible to eliminate or reduce HA to single digits or get it trending to zero? Maybe sanitation and nutrition is already optimized such that we will not make much of a dent? maybe there is an age switch for most people that cause death by one or more means because it is just our time to go? It would seem that women have a distinct hormone switch that does this?

-Side note
Sorry Dr. K, I believe that SANITATION and NUTRITION have done far more for far more people than any other industry or science can claim. Nearly the end of all diseases followed these developments with disease mortality trending to zero universally where sanitation and nutrition were applied.

Apparently, Sanofi and the likes are getting ahead of themselves. The CCTracker, when fed with random and perfectly healthy data, even according to current gospel (I tried age 48, male, white, non-smoker, no treatment of any sort, 210 TC at 150 LDL, 60 HDL (which should subtract one risk point) and 120/80. It came back as hypertension stage one. WTF?!? Be ready for the next update 5 years down the road that will declare a target of 110/70…

By the way, if you want to play with the tracker, some readers at NYT have commented that it does not reset properly, so be sure to start it in a new window.

Ok, after some playing:
– cholesterol does not matter, period
– diastolic must be 79 or lower, otherwise it will display stage I hypertension, so it does exactly what the table below the score says (stage I = 130 -130 OR 80-89.

Why this huge emphasis on diastolic? I noticed that compared to a few years ago, there is much more emphasis on isolated diastolic now in patient information brochures.

I think it is difficult to accurately measure this as diastolic takes longer to settle.

I am happy to see that many with here believe that going low carb tends to reset the metabolic system by increasing our sensitivity to insulin. We then homeostatically reduce the production of insulin and thus the circulating amount.

When you are going very low on carbs you enter into a ketogenic state which I also believe is very beneficial in the same context. Talking about a general J-curve I don’t think that this applies to carbs since what I understand carbs is the only nutrient we can live without. if we are eating too little carbs the liver start producing the glucose we need from fat and proteins.

Could we go too high on fat? I guess so and the limit seems to be at about 80 % above which you start feeling disgusted. (An experience made 100 years ago when experiments were carried out at the Bellevue hospital in NY on the arctic explorer Dr. Andersson when he returned home after having lived among the inuits in northern Cancada.) From a general point of view perhaps 75% fat and 25% protein may then be optimal for our health.

Humans cannot synthesize carbs from fat. You can get some glucose from the glycerol used to make triglycerides. One glycerol plus three fatty acids = 1 triglyceride. Two glycerols = 1 glucose molecule. Thus, if you break down two trigydeides for energy you will end up with one glucose molecule. This may be the ideal fatty acid to glucose ratio for perfect health? You definitely don’t want to eat too high a protein diet, that does seem to lead to problems.

During complete starvation during a period of time, when all deposits of starch in the body are exhausted, the most important part of our body, the brain, is still running on 25% glucose.

Within the “LCHF-community” it is usually recommended not to eat more than one gram of protein per kg weight and day. At 75 kg that corresponds to about 200 grams of meat containing roughly 30 % of protein.

How high is high? Just looked up Atkins, one figure I found put protein at 35% of calories, which is about a pound of meat per day, i.e. a lot to non-Americans. Atkins is considered safe according to some studies.

By the way, I like your writing. Bernhard Lown has a very special voice, whether he recounts his time in med school or his subversive tactics. But so do you.

This discussion really makes me think about how we, as humans, are so keen on finding definitive answers and ideal ratios. Before all these advances in technology and diagnostic tools we just knew what to eat…and how much…just like other animals seem to. A few hundred years ago we didn’t know anything about ‘essential nutrients’ but we survived. I am trying to determine whether this information and analysis overload is better or worse for us.

Craig E, I think the information and analysis overload makes it worse. It causes us to spend hours trawling through posts and referencs from blogs like this. Even a short while back the number of posts were far fewer. Then more people started getting drawn in, now we have many postings by some, but is it going to make a difference? It might if you were a mouse, or a fruit fly.

Agreed Dr. GS, with many observations. Especially on Carbs, but specific carbs are being measured in the PURE study and are seen as a J-curve too. Maybe they need to test man made or purified products? Maybe they need to look at glyphosate levels in the grains that can certainly confound results?

From the study
“In both healthy subjects and those with cardiovascular disease, the peak exercise capacity achieved was a stronger predictor of an increased risk of death than clinical variables or established risk factors such as hypertension, smoking, and diabetes, as well as other exercise-test variables, including ST-segment depression, the peak heart rate, or the development of arrhythmias during exercise. Our data also confirm the protective role of a higher exercise capacity even in the presence of other risk factors.7-9,24,25 In all subgroups defined according to risk factors, the risk of death from any cause in subjects whose exercise capacity was less than 5 MET was roughly double that of subjects whose exercise capacity was more than 8 MET (Figure 1).”

The most interesting finding, especially among men, was the strong association between survival and results from the exercise test, including high exercise capacity as measured by MET, high HRR after 4 minutes recovery, and high systolic BP rise during exercise. The prognostic importance of these factors greatly exceeded that of common prevalent diseases such as diabetes, hypertension, asthma, and angina pectoris/previous MI as well as that of conventional risk factors such as smoking, high BP, high level of TC, low level of HDL-c and obesity.

So based on everything we know, FOR MEN: Exercise has the largest effect of anything, on all ages on all types of patients. this agrees with what I have been seeing in the data. Huge percentage leaps and improvements. The women data was confounded and pointed to white blood cell count???? Maybe they are more likely to die from low immune system?

I’ll be heading off to the gym now for my 1-2 per week weight session, have to increase my walking when not hiking. I hiked in Yosemite 2 weeks ago, 9000 ft of elevation change in 8-9 miles in 5 hours. Exercise has certainly helped me, BP from 120/80 lifetime to age 50 to 100/71 by late 50’s. Resting HR from 72 to 66.

I am a big supporter of improving exercise capacity but saying that capacity is a strong predictor or mortality is really stating the obvious. How do we maintain reasonable capacity as we get older, walk swim and cycle. Choose one or all and exercise, dont train.

Smartersig
Improving exercise capacity may sound like stating the obvious, but from what I see around me it is a message that certainly needs repeating. In an Einstein sense, it seems that keeping our bodies moving and beach ready seems common sense to me, pity more don’t do it.

Mr Chris, people need a reason to exercise, here are a few:
-movement is essential for vascular maintenance, need some movement all day
– prevent stagnant lymph
– assist capillary flow to prevent hypoxia, electromagnetic propulsion might not be enough
– vascular system is dynamic, new blood vessels formed to meed increased demand or get pruned when demand decreased

Steve
Thanks for that link, it fits in with á lot of stuff I havé been reading, especially ” Age is just á number” by Charlie Eugster who took up sprinting at 90. Many seem to accept that diminishing mobility with age is inévitable, I don’t.

Mr Chris: I don’t either. This is why, in addition to all the activities I do, I do mobility exercises, focusing mainly on hip and shoulder. Very simple to do. Because of this I can do things that were difficult or painful before, like bending in the garden planting the garlic (or onions for that matter).

Dr K
About Fixx, is there not an inherited heart condition that makes you liable to drop dead when doing extreme exercise. Where I live there was a man who kept a bike shop, one time winner of Paris Bordeaux, and his son also keen cyclist both dropped dead in these conditions? Or is this question too vague?

Personally I make nothing much of it. Just as when James Fixx, the great promoter of running for health, died of an MI, aged 52, whilst out for a run. You can do things to change the odds, but you are never going to get the risk down to zero. I am just glad to have dodged the bullet so far – what, with my cholesterol level of 7.5mmol/l. [I will only crow about it, when I get past eighty].

Dr K, I’m sure you wrote a couple of years ago that you didn’t know your own cholesterol level and that you had no desire in ever finding out. What made you change your mind?

I wish they wouldn’t use “risk of death” as a measure. I’m never quite sure what it means. I generally translate it as “your chance of dropping dead from X in the next 12 months”, which is a bit of a negative way of looking at things.

They should take a leaf from the engineering book and use “mean time between failures” (MTBF), the predicted elapsed time between inherent failures of a mechanical system, during normal system operation.

In medical terms, this would be MTBD (mean time before death) or more realistically MTBMMI (mean time before major medical intervention).

But hang on a moment. These life expectancy tables are based on ordinary people, most of whom in their later years will be on several medications and might have had one or more operations.

Are there any life expectancy tables for First World people who get no medical therapy of any kind? Then perhaps we could compare the benefits of various medical interventions.

Ideally, we would want to choose therapy so everything goes wrong at once, with a little bit of warning so we could settle our affairs. So if your cancer MTBD is 8,000 days and your heart MTBD is 6,000 days, take the heart medication and ignore the cancer medication. And if exercise extends everything by 1,000 days, get off your butt and start moving around.

Did the people of the Mediterranean visit doctors when they felt ill? How many medications did they take? Did they let nature take its course and wait patiently, in the sun, till they felt well again, while they sipped Grandma’s home made chicken soup? Less medical intervention, longer life?

With all my arteries severely clogged everyone is easily passing me when I take rides on my bike. The collaterals are good for survival but they poorly compensate for the loss of the main arteries.

Well, today it is anyway too cold and windy for bike rides to be enjoyable so instead me and my wife are planning to take a tour into our nearby forest were we will be shielded from the wind. As usual we will most probably have a cup of coffee from a thermos and a couple of slices from a wild boar steak while resting on a log – part of a parasympathetic exercise.

Still, working with the hoe in the garden to achieve my maximum HR seems to have been a pretty good idea from what you now put forward. But again it is now too cold for that kind of exercise.

BTW – my Ketonix just told me that I am in medium ketoses (about 30 PPM) thus burning fat and makes my brain work but probably with very little effect on what is sticking on the inside of my arteries.

Based on my soon twenty years of personal CVD-experience I believe that it is unfortunately a one way process. I have never come across any convincing evidence that you can reverse stenosis although there seems to be many who want to make money on obscure cleansing procedures. To me there must be strong evidence in support if you are going to spend a lot money on some procedure. Old Rockefeller had a number of heart transplants but he had a really a lot of money to spend but finally they didn’t help.

I had a friend, much younger than me, who also suffered from CVD and spent some money on such cleansing procedures to no avail and he also passed away soon afterwards. Though in his case it was definitely severe social stress that finally killed him on Christmas Eve.

Writing this reminds me of when we many years ago during Christmas time were on our way to our family to celebrate the holiday and made a stop at a resting area and an old man of another family just dropped dead in front of our eyes. His relatives told us that he had suffered from CVD for a while.

My guess is that one can only slow down the deteriorating process and here my present belief is that a ketogenic state is very beneficial for people like us and of course as Malcolm stresses all parasympathetic activities like being among friends having a glass of wine or a scotch or to have a cup of coffee sitting on a log in a forest.

Collaterals is evidently the homeostatic response to the stenosis progression which is logical to my mind. Stenosis is as I understand it scar tissue which tend to stay more or less intact forever.

Your post invites a response but I feel it is now better to keep shut as anything that suggests a contradiction to this view is seemingly pounced upon as if suggesting some wonder elixir from a man in a white suit outside the saloon

smartersig: Please continue to contribute to this forum. I am not convinced that stenosis of the cardiac arteries is reversible. Convince me. How much evidence is there? The rat fat-melter drug appears to reduce plaque size in rats, and plausibly could do so in humans, but a complete or near-complete blockage I suspect would be a different matter. Seems like it would make a permanent, irreversible change in the elasticity of the artery wall. Really hard to type with a cat walking back in forth in between the eyes and the monitor and rubbing everything in the process!

Dr Goran,
I’ve read your many posts carefully. It seems that you had luck and genetics on your side with your experience of twenty years ago. After all, many younger people do not survive their first cardiovascular adventure. CVD still kills. Not everyone is aided by their collaterals. I suppose it depends on the nature of the particular event.
You’ve been happily successful in managing your own situation since. (I look forward to the book!)
Here you describe CVD as a one-way process. Please permit me to ask a sensitive question.
It would seem that if you continue to avoid bears and wolf packs while having your coffee in the woods, there’s some likelihood that you’ll meet your end cardiovascularly.
What would you do if it became clear that you were having a heart attack now, after all your successful efforts?

To throw ideas into the debate to be confirmed or refuted politely. If I come away thinking my god I think I got that bit wrong, I will be delighted. I have done this many times over the last 5 years. Last night I had calves liver with lots and lots of veg, why because its a hugely nutrient dense food and once in a while is good. The most important thing…. no pudding except some fruit and no bread

MR Chris, Did you read the discussion about a newish ‘drug’ that reduced plaque in mice arteries in the last blog. And somebody then followed up by suggesting that extract of magnolia root bark could do this also.. I repasted that commet here…
Do I know anything about this ? No I do not. And Dr K was somewhat skeptical as well..

But those of us who live here are seem to be contrarians by nature with a very healthy dose of skepticism towards the standard medical methodology for CVD.

Bill in Oz
Certainly read about the wonder drug that clears plaque in mice, unfortunately I am not a mouse.
I also read about magnolia bark.
I also asked Göran about unclogging arteries, and he gave, me an answer making, I think a sensible distinction between clogged and plaque.
I learn from most people on here, thanks to you all.

There has been talk here of the new USA blood pressure standards.. And in recent months I have been measuring my bp twice a day.

Something My lovely caring lady will not let me forget. 🙂

But the past 2 days something quite weird has happened. Last night it was higher than usual 146/79 so we remeasured a moment later. Then it was 137/76.. IE Systolic pressure was 9 units less. This morning we did the same thing out of curiosity. The first time it was 151/81 and the second 137/78.
And finally just now here this evening ( 11.05 pm here ) we did the same. The first was 153/73 and the second 145/70…

So Dr K I am puzzled. What is going on here ? We’re using an Omron HEM 7200. But if there is that much natural variability in BP just a few minutes, what significance do these measurements have ?

By the way, all this is far far better than a month ago when my BP was regularly around 176/98 — 181/93 ! And I had no joy at all from taking the doctor’s meds. !

But since then, thanks to Goran’s suggestions, I have been taking the Kyolic garlic capsules 3 times a day…

I think one benefit of regular monitoring throughout the day is that you can begin, over time, to correlate the changes to other things. I have learned from personal experience that eating wheat and taking ibuprofen increased my BP. Both would consistently cause a significant rise within 24 hours. However, the biggest factor was the alignment of my thoracic spine. If T3 or T4 were “out,” my blood pressure would be elevated. A chiropractic adjustment would bring the BP down. I have since confirmed with several other individuals that this constellation of wheat, ibuprofen and spinal alignment affect BP; not a controlled study by any means but interesting real-world data…

You need on take resting (sitting) BP rest for a few minutes, take 5 measurements from each arm. record all data, Then take the average as your useful number. I would do this a few times per day to see how this changes over time, plus after meals…Make sure to take HR too.

My approach for me if I was worried about BP: I would do it every other hour or with any changes Then I would have a huge statistical baseline with ranges, standard deviations, etc so you can see what to expect. then when you fall outside the expected ranges, then there is probably a root cause associated and maybe then start to worry a little.

After that if you want to have fun, do standing BP, lying BP, pre and post exercise BP and include HR.

for basic expected normal distribution, this is called 3 sigma (sigma = standard deviation). Take the average and the standard deviation in excel. Then multiply the standard deviation by 3 and add this to the average, that is the expected upper limit. Then minus 3x the standard deviation from the average, this is the lower limit. this covers 99.8% of the expected range for you and your machine. If you go above or below the upper and lower ranges, then there is what we call an assignable cause.

You can call the company and ask fro their gage R&R study and this would give you the machine variation within the measurements, probably not much more help.

Sorry Steve, you have not answered my question. Why is this happening ? And what is the significance of three different measurements within a few minutes ? Your suggestions are well intentioned are frankly I do not intend to spend my life waiting around measuring BP.

Bill in Oz, in the world of measuring things, the device that interfaces between the outside world and the processing electronics are the most problematic items. Microphones, photocells, speakers, pressure sensors, thermocouples etc, It sounds like a “sticky” pressure transducer. I think more measurements are needed, but if you get in, say, 20 sessions, all giving the same differences, then the machine is faulty.

Bill in Oz: This is why I completely stopped taking my BP at home. It is what it is. I’ll croak when I croak. Meantime, I’m living life to the fullest. I feel good. I think our mental state has a powerful influence on our physical health. So taking tests every five minutes can’t possibly be good, because if something appears “out of range,” we’re going to be thinking about it. I say, to hell with it.

My OMRON wrist unit gives differing consecutive readings of BP. It is also more affected by placement. However, it has a function that averages the last 3 readings taken on a single session, and this is the number I use. The few times I’ve taken many readings, shows a trend towards centering on this ‘average’
An old fashioned arm cuff seems a bit more consistent, though not worth the hassle. I view BP as a guide not a binding contract !

The Omron tool is far from useless. Generally, upper arm instruments are almost foolproof, but there are also good wrist instruments. Omrons tend to be excellent from independent testing that I have seen. Machines that measure while inflating rather than deflating induce an eerie feeling so may be systematically off.

After the fuzz a nurse made in a work related checkup, I looked into that in detail. I realized very quickly that being relaxed and taking a few minutes is important, as I would always get readings in the normal range after a few minutes, and variability became low. To rule out systematic errors (my wrist meter that we had bought at Aldis when my wife was pregnant might be malcalibrated or have run out of calibration from sitting in a shelf for years), I bought two others, one of them an Omron. No signficant systemtatic error.

So I agree with Steve that taking several measurements a few minutes apart is important, but I would not worry too much about the variation (= noise) of the machine. Much of the variation is the actual blood pressure.

If I walked around in the house, picking up the machine and plonking down somewhere, the first reading might be 150/100/88, the second 130/ 95/80, the third 122/89/65 and the fourth 117/77/68. So the disastolic takes a lot longer to settle, especially if you are worried and agitated about your BP. Try reading something fascinating and hitting the button from time to time while focussed on a riveting story. You should get pretty consistent numbers which very by maybe 5 units from reading to reading.

So unlike Steve, I maintain that settling and calming down are important, and if any averaging is to be done, then on numbers when you really don’t care about the measurment any longer. Alternatively, maybe your GP can lend you an automatic device for a day or two?

Bill in Oz, I have the same experience with BP measurements. My explanation for first reading to be high: sympathetic reaction to having blood flow to arm being cut off. Next reading you are aware that there is no danger and you are more relaxed and BP drops. Best use for home measurements is to have evidence that you can show to your doctor that there is no need for him/her to medicate your BP. Now I take 2 readings morning and 2 readings in evening for a week, done once a year before annual checkup.
Another use for checking BP would be to monitor effect of dietary/supplement changes.

Re the Omron measuring.. Some background info :
1 My wife is a nurse with 13 years hospital employment…
2 : She always has me sit down and sit & relax for a minute or so before taking my BP.
3 : I notice & have noticed for months that the cuff when inflated is so tight that it is uncomfortable – even though it is fitted to my arm
4: I notice that if the OMRON ‘ pushes the pressure in the cuff up to around 300-210, then always the BP readings are very high.
5 : If the cuff is inflated to say 180-170, then the BP measurements are invariably lower.

6 Hypothetically this should be a reflection of how much pressure is needed to stop blood flow. But as the measurements are being taken just a minute or so apart with no other changes happening, I suspect that it is in fact an artifact of the machine itself ( Faulty ? )
6 : Today my lady found a Remington wrist bp measuring device second hand in a Salvos Op shop for $10.00. She bought it for me.
7 But I have declined to use it until we know whether it is accurate. She then used it on her own wrist. a few times and gone very different readings They were : 115/67, 110/68, &107/87. Clearly she has no bp issue. But even for her in a matter of minutes the machine generated different results.

I am inclining to Gary’s view on this After all all it may be delivering toxic worrying news !!

Gary,
I agree.
Fretting over getting your BP measurements just right will elevate them. I do it five days at a time, two to three times a day, three measurements each – after relaxing in a comfy chair a full five minutes. I do the 5 days only in the lead-up to a dr. appointment so that when my BP is elevated in his office, I have something to show him.
Once. Only once did I have an office measurement done properly.

Get an occasional anomalous high measurement? Consider this:
Most people get the occasional skipped beat, or premature ventricular contraction/complex. (PVC) Perfectly normal. There is a bit of a gap after the premature beat followed by a stronger one, then normal rhythm resumes.
If your machine measures on the deflation and you happen to have a PVC early in the deflation, it could register as your systolic — high systolic because of that follow-up beat. It happens. I confirmed the idea with my electrophysiologist.

Eric,
Everyone is different. You might ask yourself how much of the day you’re sustaining 150/100.
Clearly, you can relax and calm everything down for a nice 117/77 with the best of us, but what harm might be done the rest of the day?
24 hour ambulatory sphygmomanometry is called for.

Bill: I forgot about those that inflate too much. Had one of those, went straight back to the seller. The variation your wife saw on the wrist instrument looks normal to me.

JD Patten: No, 24 h measurement is not called for at all. It is perfectly ok to have 150/100 right after charging stairs three steps at a time and just sitting down or after any kind of exertion or (positive) stress as long as it returns to normal at rest. Saying otherwise is akin to suggesting we should all turn into couch potatoes.
I went to the bottom of that when the work nurse had me unnecessarily worried and probably ingrained an allergy to white coats and measurements. In the end, if it goes down after 5 – 10 minutes and especially when you have ceased to worry about the measurement, it is fine. Also, I was hospitalized for a few hours each after two minor accidents in the last year or so, and they had me hooked up to a telemetric ECG and RR and it was perfectly fine both times. I also measure RR from time to time as I have retained occasional tinnitus after one of those accidents which involved neck trauma to make sure it is not related to blood pressure, which it isn’t. It is triggered by swimming breast stroke, playing Badminton or jumping in place while pulling my knees to my chest (is there a proper word for that), so can probably be safely ascribed to the neck.

Eric,
Ah! You said, “If I walked around in the house…” I would expect 150 “after charging stairs three steps at a time”!
I’ve mentioned before that weightlifters can go over 300 systolic during a lift. They generally keep close track of such things and back off training if it doesn’t come down reasonably soon after.
I don’t know if the same can be said about body-builders. Did Arnold Schwarzenegger keep close track before he needed a valve replaced? He now deals with atrial fibrillation. One prime risk factor for AF: sustained high blood pressure.
That’s what “they” say. I’d like to know what they consider the threshold to be for risky pressure. ??

And my cardio performed like a pork chop at a Bar Mitzvah when I confirmed my use of k garlic in place of Holy Aspirin… The reason that “all” previous stents were clotted 100%….
Since the resulting CABG x5 I’ve kept to Aspirin and Plavix… And continued the garlic. A year on, and not everything is going perfectly in there….
Odd how two cardios have opposite advice, which one is Fact and which is Opinion???

James – Indeed a very interesting experience you share with us. Some cardiologist indeed consider themselves as Gods.

My wife when attending a biological experiment at a university course the students noted that the action of aspirin on living cells in a test tube was scary. It certainly stops the renewing process of the cells by division. All students in her group decided on the spot to never take aspirin. “The power of observing!”

“My wife when attending a biological experiment at a university course the students noted that the action of aspirin on living cells in a test tube was scary.”

I am curious, was the concentration of aspirin adjusted to something like the physiological levels expected in the body. I have taken a low dose aspirin for many years – partly because I know there can’t be any pressure from big pharma as it is too cheap!

Ahh Goran, how puzzling ! Here I am a long term grower & eater of garlic, and I did not know this about garlic.. In fact I remember contradicting you for exactly this reason about 6 weeks ago

But then you mentioned that only fresh garlic has this effect on the arteries and suddenly I realised that most of the garlic I eat is cooked…

So I have been taking garlic capsules since then and my bp levels in general have fallen….Something that the medical prescription did not do since August when I started taking them with woosy side effects…

Fresh garlic also has the advantage that you are less smelly after eating it…

The worst offender in terms of taste and body odor IMHO is dried garlic powder that you can buy in jars and that is in pasta sauce and frozen pizza. Probably akin to milk powder, egg powder or the cholesterol that was fed to those poor rabbits in Russia about a century ago in that it is nasty and highly oxydized.

Bill in Oz: Thanks for letting us know garlic has helped lower your BP. I’m going to begin putting raw, diced garlic on my eggs in the morning, rather than cooking it with the onions. Are you taking Kyolic garlic? This is aged, I believe. Better than plain garlic?

Bill in Oz: I had another thought: Much of the garlic I eat is fermented. Might this have the same effect as the aging in Kyolic? Also, fermented foods are good source of vitamin K2. I highly recommend Dr. Mercola’s recent interview with Dr. Kate Rheaume-Bleue about K2.

Gary, I have daily BP measurements for the past 4 months, starting on August 4th. when my GP first spotted that I had a high BP up around 190/90 and occasionally higher.. ( Bugger !!)

I gladly tried the eds prescribed : Irbesarten at varying strengths to no effect at all on BP – except some occasional woosiness; then Amplodipine at varying strengths again with no effect on BP but more frequent woosiness.. And finally Idaprex which is a combination ACE & diuretic medication….Again with no effect on BP..

I started taking Kyolic garlic capsules on the 31st of October. And since then my BP readings having gardually gone lower..And now are regularly in the 140’s/ 75-80 and occasionally in the 130’s..
I see the GP on the 22nd and will be presenting him with a complete listing of my BP readings… And suggesting he recommend fresh garlic or Kyolic garlic capsules to his patients , instead of the prescribed meds.. A bit more expensive but far more effective..

Of course in all this discussion I am relying on the accuracy of the bloody Omron 7200 BP measurement device. And that is an issue !!

Bill in Oz: Amazing that the BP drugs had no effect. With me they did. I really think you should have confidence that your home BP readings are reasonably accurate. Read the study Andy S linked to. Seems aged garlic has a significant positive effect on all sorts of cardiovascular markers. They used Kyolic aged garlic capsules, 2 per day containing 1.2g.

Bill, here is a study showing effect of aged garlic extract:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734812/
“Conclusion
Our trial suggests that aged garlic extract is effective in reducing peripheral and central blood pressure in a large proportion of patients with uncontrolled hypertension, and has the potential to improve arterial stiffness, inflammation, and other cardiovascular markers in patients with elevated levels. Aged garlic extract was highly tolerable with a high safety profile as a stand-alone or adjunctive antihypertensive treatment.”

I am looking for ways to preserve my garlic crop by ageing/fermenting. Yesterday prepared one jar of crushed garlic with honey. Today will do the same except add ginger.

AndyS: Super! I have long put garlic in my ferments, but am going to put a lot more in the future, since I have an abundant crop this year. Soon it will be kimchi- and kraut-making time. Chinese cabbages are growing so fast! I’ve discovered this year that cruciferous root vegetables, such as radish and rutabaga ferment beautifully. The added bonus with ferments is the vitamin K2. Thanks for the link. This study was done down in Bill’s neck of the woods.

A follow up on the Omron 7200..
My lovely lady got me to again do my BP with it.. But it pumped up the cuff so tight it was painful…And then gave a measurement which was very high 175/94..
I tried again with the cuff deliberately loose and it [[umped up the cuff to over 230 Duhhh ?
So I stripped out the batteries to delete it’s memory & tried again Again it pumped up the cuff so tight I took it off my arm….
I have stripped out the batteries again and we will try again in the morning.. But if it does this sort of thing again, it’s going back where it came from.
Do Omron really think that their BP tool is useful if it’s inflicting pain on the users ? My frank opinion : High tech shit !

Bill . . . this is crazy . . . I have just found myself noting down the 22 Nov in anticipation of you BP consultation at the your doctor. As time goes on we seem more and more to be invested in each others’ health!

I ask because some months ago I planted a piece of sprouting ginger in a pot to see if it would grow. There was another plant in the pot which died so I stored the pot in a corner and forgot about the ginger.

The other day I needed the pot so I turned out the dry soil and dead plant, and there was the ginger I had forgotten about, dirty, but otherwise in remarkably good condition. It hadn’t dried out and shrivelled up like old ginger in the pantry. Apart from dried-out cut ends it looked almost as good as new.

So I cleaned it up and started using it. It’s lost about 1 or 2% of moisture, and some of the sharper ginger flavour, but otherwise it’s fine. In fact I have some in my turmeric I’m drinking right now.

Martin garlic buried in sand will not ‘age’. It will at some point sprout and start to grow.

However exactly when it does this depends on the climate in your area. Garlic is genetically programmed to break dormancy in response to certain temperature and moisture triggers.
Garlic stored in a warm kitchen through Winter will sprout late the following Spring. Contrawise Garlic stored in a cool room will spout much earlier, here for me, in Early Autumn.

I suspect that garlic is ‘aged by some process like smoking it. But maybe Gary or someone else here is better informed on this than me.

Bill in Oz: I don’t know how Kyolic ages their garlic. Dr. Mercola has an article about Korean “black garlic ” but I’m pretty sure it is a different process. I suspect the traditional fermentation process enhances the health-promoting effects of garlic, so I’ll stick with that, in addition to eating it raw and cooked. To be on the safe side, I just bought the Kyolic garlic, and am taking 2 600mg capsules twice daily, as they did in the study,

Martin, garlic is aged to reduce garlic smell and make it easier to eat while preserving the health benefits associated with raw garlic. The ageing process is more like fermentation. There are several methods on the internet that I am interested in trying.

My wife and I found 3 years ago that changing to LCHF (strictly followed, and locally known as Banting {Prof Tim Noakes}) our BP (and weight, diabetes etc.) reduced over 5 months to more normal ranges. Garlic plus beetroot plus supplements are considered standard fare. So much so that our GP had to rapidly cancel all BP meds. He considers us to be his *Star* patients.
For us it worked.

Hi Robert, Thanks for your comment. I know about the LCHF diet and in fact followed it for a while.

But it seems my body did not adapt to it very well as it was then that high BP developed…Ummm ?
As a consequence, recently I have gone back to higher carb diet with whole grain breads and sweet potatoes making up those carbs. with, lots of salads, fruit. My protein sources now are yoghurt, cheeses, full fat milk, fish, legumes & occasional meat. And of course butter, olive oil & coconut oil but no industrial oils at all. I eat organic & home grown whenever possible. But very, very few bought processed foods or deep fried foods…
I do not recommend this for anyone else. As I’ve mentioned before, we are each the result of genetics, diet cultural history and our microbiome….We are all N=1 experiments….

“Recent discoveries show that inefficient metabolism because of mitochondrial dysfunction in skeletal muscle and vascular smooth muscle can cause the elevation of systolic blood pressure and may be involved in the development of cardiovascular conditions, such as hypertension.3,4,12”
“Localization of Mitochondrial Dysfunction to the Brain Stem
Having identified assembly defects at the whole-brain scale, we targeted the brain stem. The brain stem is involved in control of sympathetic nerve activity, the set point of arterial pressure and baroreflex control; these 3 mechanisms are essential for homeostatic regulation of arterial pressure.33 Our studies revealed proteomic abnormalities in connection with impaired respiration, deficient ATP production, and elevated ROS generation. The dysfunction of mitochondria in the brain stem in hypertension is likely to affect the regulation of cardiovascular homeostasis.”

Take home message is that altering carb/fat ratio takes time for the system to adapt with resultant fluctuations in blood pressure. Another point is that medicating BP to slow down the heart misses the cause of elevated BP. Perhaps BP rises with advanced age because of reduced ATP production. Next- what influences mitochondrial health? Hydrogen sulphide from garlic could be one factor.

Bill . . on the keeping track of other commentator’s experiences . . . I do so agree that the stories of what works for us and what does not, are so very important. Yes, we certainly share information, I have pages of notes culled from this blog, not to mention the stunningly, definitively informative references supplied by Steve and others; though I am not sure where I am on the personal wisdom front.

But for all this, I do feel the blog has a socially positive, and therefore heart healthy, aspect, and that people here do have genuine concern for other’s welfare. Reading the stories of peoples’ successes brings pleasure; reading about their battles with medical establishments gives strength in our own battles; and there is even the chance of finding the odd lifeline.

At the end of the day, I look forward to learning how people are faring and wish them well in their health endeavours.

about your NIR light enhances life span in drosophila link, 670 nm is actually visible leight (which extends all the way to 780 nm). A good source of red, IR and NIR is the good old incandescent light bulb. There are also 670 nm LEDs available with very good efficiency which are marketed as deep red.

Keep in mind that the IR right probably shone right through the drosophila, and that the proposed mechanism is supposed to happen inside of each cell. There is simply no way to shine through the human body with red or IR light. That being said, it could possible rejuvenate skin and retina, but I’d be careful with too much deep red light as the eye is not particularly sensitive, so iris and lid reflexes may be delayed, which might result in a fried retina.

About the drosophila article, they write that 670 nm energies (should really read power densities, those bioscience and med folks again!) were 100x lower than indirect sunlight, at 40 mW/cm². Now, this is 400 W/m²!!! The solar constant is 1367 W/m², measured outside the earth’s atmosphere and integrated across the whole spectrum. In central Europe (49° N), it is about 700 W/m² at noon on a clear summer day. Indirect sunlight is probably half of that. So they already put more than the full spectrum’s power on a clear summer day into a single wavelength.

you get a power spectral density of about 1.4 W/m² / nm in free space and 1.15 at 49° N. The spectum of the deep red LED on page 6 of the Lumileds document shows a half width of about 15 – 20 nm, so if you take a 17.5 nm slice out of the solar spectrum around 670 nm, you get 20 W/m², again, probably half with indirect light.

So rather than 100x less, they used 20x more than the solar spectrum. If this is emitted from LEDs with a clear lens, I am worried about the effect on the retina.

Eric,
Apparently plants convert sugar to energy in their mitochondria similar to what we human and all animals do. Therefore assumption is that infrared radiation stimulates mitochondrial energy production in plants as well as animals.

AH,
Saw John Bergman videos a while ago, good info.. Doing research for my wife’s back problem (75 y). Chiropractor visits were futile. 9 months ago doctor said she will be in wheelchair due to lower spine vertebra osteoporosis, operation to fix not possible. Walking or standing was difficult and painful. Increased vitamin d to 5k units per day, supplemented with collage, plus green juice (carrot, beet, apple, greens) result is that bone density has increased and walking is now pain free. The IR light therapy might be beneficial for disc and spine regeneration.

Rex Newnham pioneered boron supplementation and wrote âBeating Arthritis and Beating Osteoporosis.â He developed a product called Osteotrace â http://tinyurl.com/y8yymukt Other boron supplements are available.

PS: There seem to be no studies about the safety of this. If it occurs in natural sunlight, it is probably ok, but 40x given in isolation, if it is known to promote growth, already has minor potential for worry. There are some folks who have proposed to use pulsed lasers to increase the penetration depth. At these high intensities, organic tissue is optically bleached so that subsequent pulses are not absorbed as much and can penetrate more deeply. Optical bleaching does not necessarily mean a permanent bleaching. It simply means that there are more electrons in an excited state than in the ground state. We are talking about maybe 1 million times the spectral power density of sunlight, so I’d really worry about promoting cancer growth here.

As for an ideal lamp, I would probably use a Philips 311 nm narrow band lamp for UV-B. This will produce Vitamin D without being carcinogenic:

There are also a couple of observational studies on patients treated for Psorasis with broadband UV-B which also show no indication of increased skin cancer risk but using the Philips is probably the safest.

I would probably throw in a bit of broadband UV-A. I am beginning to believe that it is UV-A that is really harmful as it penetrates more deeply and does not necessarily kill a cell after damaging its DNA (gee, thanks for those UV-B only blocking sunscreens we had in the 70s and 80s). Using UV-A sensibly with added UV-B for balance is probably safe and makes for some nice NO generation. Those light healing guys at Boltzmann institute in Vienna have also had good success with 475 nm which is really just blue, so maybe throw that in, too. I’d also want some deep red, far read and probably near IR LEDs in there, too, but not at more than solar levels.

CRI80, if high quality from Nichia, peak at about 580 nm and are down to about 15% of peak by 670 nm. Chinese models usually have a green tinge, which means higher efficiency (because the eye is more sensitive for green) but less red. Most LED bulbs sold these days are CRI80.

Modern office lighting is usually equipped with a triple narrow band phosphorous blend and has a light code of 840 (CRI > 80%, 4000 K). it has a narrow peak at 610 nm and some intensity out to 720 nm. Light code 827 is probably what you get in most big name branded ESL lamp, also with some but not much far red light. Surprisingly, the old 640 and 765 single and dual band light codes that are found in industrial lighting have a surprising amout of red, probably close to a CRI80 LED.

Takeaway: modern light sources are not lacking in deep and far red light. High quality CRI90 LEDs probably have more output in this 600 – 800 nm IR window than traditional incandecent light bulbs. Those old thermal light sources have more output at 800 – 2000 nm, but penetration depth in tissue is minimal.

..one of the worst things about civilization is, that anybody that gits a letter with trouble in it comes and tells you all about it and makes you feel bad, and the newspapers fetches you the troubles of everybody all over the world, and keeps you downhearted and dismal most all the time, and it’s such a heavy load for a person.

Just read that Guardian item and am now wondering what connection there might be between the rise and rise of heart disease and the rise and rise of NEWS in the last century. Just a thought. I must go away and have a good hard think. All that horrible stuff we see nightly on the television, about which we can do nothing at all and which just brings about feelings of lacerating helplessness and quite often fear. And, of course, feelings of guilt, twofold, because a) I live a fairly cosy life here in the U.K. and b) because it seems so wrong to turn away from the horrors of our world because “what can I do? Nothing. Knowing makes no difference.

I am here in Oz & I have exactly the same response as you Jan. It’s long time since I watched the TV news on any channel.. And this morning I scanned through the ABC & the BBC web sites in 3 minutes. I think I read exactly one ‘story’ of something local to South Australia..

Eric
How ironic that the Guardian has published this story. I am a bit of a news-aholic.. So I looked at this story from the Guardian with interest..And found this
” News is toxic to your body. It constantly triggers the limbic system. Panicky stories spur the release of cascades of glucocorticoid (cortisol). This deregulates your immune system and inhibits the release of growth hormones. In other words, your body finds itself in a state of chronic stress.”

I assume by news this story means ‘BAD” news and 95% of the Guardians stories are in reality is preaching from the pulpit about the hell that awaits through alarming stories.

I’ve come to the conclusion that that just like the fundamentalist preachers of old, they are toxic
And so some months ago deleted it’s bookmark in my brouser. I still get the daily emails of the top stories.. But I only read the science & health ones and often not even them..

I have stopped viewing some other daily news & blog sites as well….Even New Scientist which was once a staple daily read has in the last decade become a vehicle for preaching stories rather than new information. Another is Quadrant here in Oz which preaches stories from the other extreme conservative end of the spectrum

A consequence of this change in my own reading, is that I have a happier daily life.. Unfrazzled by all the BAD bad stories that the Guardian, among others wants me to be alarmed by…

Eric:
A lovely article! We don’t buy papers or watch TV news. Radio headlines are generally quite enough and you don’t get distracted by people’s attire and smiles. I certainly don’t want to see the likes of Tony Blair laying a wreath at the Cenotaph. Things like that are really anger provoking. We like Radio 4’s News Quiz though. It brings you to people who are still able to think and see the flaws.

Thanks Antony, following up all the links was a goldmine of useful ideas. – Already taking the L-Arginine, just need to ramp up the dose… 🙂
Yes, there IS a lot of evidence that stable angina is better treated with Optimised Medical (Medicinal) Therapy, a.k.a. OMT and shifting the calcium to where it should be is part of it.
My (ex) cardio has never suggested a CAC score, so I suppose it’s only relevant to US Presidents, Astronauts, Irish Engineers – and Retired Aussies visiting Bali for EECP. 🙂

Martin, re coke and plaque: unfortunately someone has already patented that idea The secret ingredient is phosphoric acid.http://www.google.com/patents/WO2012087434A2?cl=en
Use of phosphoric acid
WO 2012087434 A2
ABSTRACT
This disclosure relates to the use of phosphoric acid. In particular, this disclosure relates to the use of phosphoric acid for treating cardiovascular disorders such as atherosclerosis. This disclosure further relates to compositions, kits, methods, and the like.

Smarter,
Nah.
My cardiac CAT scan of a few years ago showed a lung spot. Of course that had to be followed with more CATs at 6 month intervals. Nothing there.
Be careful what tests you go for> They’ll find . . . something.
That radiation concerned me, so I was sent to a particular rheumatologist – necessarily knowledgeable about radiation doses.
• Lung scans are fairly low dose. Soft tissue.
• CAC scans are even lower, now.
• Any cancer you might get from these scans would only show up 20 to 30 years later.
• Most candidates for CAC scans will be gone by then anyway, being the old guys that we are.
How old are we? I’m 73. Anyone else forthcoming?
(Smarter, you do have Google, yeah?)https://www.google.com/search?q=agatston+radiation&ie=utf-8&oe=utf-8

J D Pattern commented
“Be careful what tests you go for> They’ll find . . . something”
I agree completely, I no longer respond to any of the offers to be medically tested. I measure my BP, and that is it, unless something goes wrong.

The problems with testing well people include:

The sheer stress involved in waiting for the results to fall on your doormat.

Some tests are obviously quite unpleasant and stressful in themselves.

Lot’s of tests throw up false positives, which may mean tons more stress and further, more invasive tests, or even unnecessary treatment.

Sometimes it isn’t even clear whether some detected anomalies are dangerous or not.

Nobody lasts for ever, and I think it is vital not to spoil the final portion of your life by overdosing on medicine!

Two tests too many, in my case.
First was to mention the exhaustion / discomfort triggered by “enthusiastic” lawnmowing. = Troponin test (blood) Dr rang me at home, 9pm, with the happy news it was “20 times higher than normal” which equates to having had a MCI – ‘Get down to hospital three hours ago… !’
Second was the angiogram, “ALL your stents are clotted / occluded” – the inference being ‘totally’…” ONLY option was invasive surgery.
Result = CABG x 5 about 10 days later…

(still don’t know how I survived 10 days with ‘blocked’ arteries…..)

Pity I hadn’t discovered this blog before I was bullied into what I now regard as a waste of money and un-necessary risk. – A 50% course of EECP worked wonders, when the grafts started to block…

David,
All true.
However: An acquaintance just learned that his PSA went from 8 to 80 in a few months. Prognosis — he might see Christmas of next year, but he won’t be able to vote for the next U S president.
Would you want to know? Would you prefer to careen downhill totally blindly till you hit the end ?

I am not really sure what you are asking me. By avoiding being tested, I obviously don’t receive messages such as the one you describe, nor do I wish to be informed if I have a fatal disease. I live a little more like my parents and previous generations did.

Regular medical tests for dangerous diseases that cannot be reliably and efficiently treated treated if found, imposes a huge stress on people – and for what?

What ? And have the Screening Industry lose profits?
I would rather be quickly taken out by an incurable disease – despite my misplaced optimism, than be ground down with constant watching, trepidation and then to linger in agony through futile treatment. Simple choice of life forever under leaden skies – or blissfully soaking up the Sun – for almost as long …

Fittingly, in a call with investors, the CEO of ProSiebenSat.1 group (a German broadcaster, best thought of as Fox minus the vile news coverage, with a somewhat conservative profile but not blatantly biased), characterized his core viewers as somewhat obese and somewhat poor, who still like to recline on their sofas and be entertained

We have mentioned on this blog the situation of Dr. John Warner, President of the American Heart Association, surviving a heart attack. It is difficult to comment on this without being overwhelmed by the irony of it all.

Anthony
I have read this letter.. And read most of his most of Dr Davis’ posts for the past 9 months. I am seriously bothered that he has created about him a whole industry of services & things, that of course can be purchased via his web site….

It’s called a conflict of interest.

Another issue : he has changed his tune over the years. In his Wheat bElly book he suggets that eating original heritage grains organically grown did not have the deleterious effects of modern bred grains.. And can be part of a healthy heart diet. ( He even lists a web site to buy the flour from such grains. ) But in his new book “Undoctorered” he more or less demands that his patients stop eating any grain foods..
And I notice that increasingly he is using projecting his ‘authority’ as a doctor in the process. to convince readers, patients..

Bill . . . I think I can understand why you are bothered by William Davis’ opinion. You are obviously more acquainted with him over the years than I have been. I am not overly concerned by message touting ‘gurus’ selling their message . . . whether by book, video or web site. Some dislike Dr Mercola or Dr Greger for this reason (I must say I do not . . but neither do I buy anything) . . . but there are also many others who have made a career out of selling their message . . . Gary Taubes, who I certainly admire, for instance. I do not begrudge any them from capitalising on their message. Whether I either agree with the message, am doubtful, or skeptical of its truth depends on the message not who is delivering it.

So, on the Davis open letter to the AHA president . . . it said exactly what I would have wanted to say. The words/sentiments were important not who was saying them. I did not know that he changed his mind over the nutritious status of heritage grains . . . but then I always see that a person changing their mind for a good reason is a good thing . . . after all we are trying to get dieticians to change their mind . . . and I sometimes wonder if part of their reluctance to change is the ignominy of being labelled as someone who changed their mind.

Anthony, Dr Davis is an excellent self promoter. And I think the letter was a self promotion exercise. That may be acceptable in some cultures but it is not with me..

Unfortunately I only borrowed the Wheat Belly book by Davis. It was published in 2008. In that he went into some detail, about modern varieties of grains which have had gene sequences from wild races of related grasses bred into them – via conventional & GM methods. In Wheat Belly he states that this breeding program is the main problem as humans are not adapted/evolved to these wild grain traits…

He then reports an experiment he conducted on himself. he got a couple of pounds of modern wheat grain, ground it to flour and then used it to make bread. He then ate the bread and measured his GI response in his blood. It was extremely high.

He then did the same experiment with old fashioned grain he sourced from an organic heritage grains farm in the USA. This time there was no high GI response and what response there was lasted a shorter time.

I remember reading this thinking as a farmer that Davis was really on to something. The Green Revolution breeding programs in the 1960-70’s sought out grains and wild types from allover the world to boost productivity in wheat, rice & corn fields by bringing in ‘new’ more vigorous genes into grain crops. Borlaug got the Nobel prize for his work. And the older grain varieties started disappearing except in the odd seed bank,

But by character or circumstance, organic farmers tend to stick to older ways…And that tendency exists in grain farmers in my experience at least here in Oz. I seen organic crops of wheat varieties here that are almost extinct among big conventional Oz grain farmers..

Now… All this backstory has disappeared in Davis more recent writings like Undoctored. He has simplified his message and now says ( among other things ) ‘no Grains’.

There is evidence that refined carbs promote heart disease and when you look at the western diet what are the common refined carb components that have become a staple in the diet … bread. Some peope virtually live on it with sandwiches for lunch and toast at breakfast.

Sadly I have to agree with Bill In Oz – Way to much promoting ungrounded narratives. I wasted time following the references in his book only to wonder how they supported his narrative.

As a heart patient – we all want answers – there are no end of people speaking in calm authoritative voiced pushing some ego fueled ungrounded narrative – often with some magic pill or herb. Getting people anxious about foods probably does as much harm as good.

I agree with limiting carbs to keep insulin levels normal – but I’m not buying into the idea that the proteins in wheat are causing wide spread harm. Could be – but IMO the case has not been made via experimental science.

On the other hand one could take the view that the most univariate connection between heart disease and food within the very large body of China Study data was overwhelmingly wheat!. This may not prove causation but given that common consumption of wheat invokes insulin spikes it could well be. From this one might ask do I need to eat wheat to survive ?, well no so goodbye wheat

Missing here is the effect of the diameter of a stent – small ones plug up.

Also missing is the idea that they need to raise the blockage number – stents don’t make sense in the 80% range – might not really be appropriate until the 97%+ range.

I’ve got skin in this game – I got 4 stents years ago for exercise induces angina – which harmed me – I instantly had shortness of breath that has never completely gone away. I later ended up with CABG that I shouldn’t have had.

I do think stress is important – and while I think that excess carbs and PUFA cause obesity I think that encouraging people to worry/obsess about ungrounded dietary narratives may also be harming people – it isn’t just the procedures doing harm.

Can you clarify for me. You had angina before you had the stents, but no shortness of breath? Now with the stents, the angina went away, but NOW you have shortness of breath? How debilitating is the shortness of breath? is it worse than the angina was?

Big Pharma and Big Agro are more powerful than us grass root victims and I guess that is why we are seeking comfort here at Dr. Kendrick’s blog.

Anyway I got rid of my TV-set more than ten years ago and my daily newspaper a little later and to tell the truth I don’t miss any of them. I want to build my own opinion about different matters of interest and then we still have internet at our disposal instead being “indoctrinated” by main stream media. In this context it is interesting for me that BMJ has invited victims like myself for patient reviews – my first one recently accomplished.

To the question on aspirin my wife doesn’t remember the details , just that they all, including the teacher, were shocked with the result. I am myself trying to remember my full rational behind skipping aspirin which also was the last drug I dropped. I guess I read something which scared me off and that the garlic basically took of the issue “blood thinning”.

You are so fortunate, having a physiology responsive to garlic, unlike mine which clotted all my stents after ceasing aspirin. I know this is true because the cardio told me so along with comments related to my intelligence and some alleged anatomical impossible behaviours…
It was only me catching the eye of a Grinning Nurse behind him that saved him from a “reply”. She later admitted it was one is best performances….
In spite of my low IQ… I persist in the belief in 3 g of aged garlic has a useful effect on platelet aggregation.

Biddy, we grow our own.. It’s late Spring/early Summer here and garlic grows best here over Autumn/Winter/Spring. And we dug our first variety last weekend. It’s now hanging up drying under the back verandah. No more bought garlic for us !! And four more varieties to dig in the next couple of weeks.
Cooked garlic basically part of every evening meal. While fresh chopped garlic is always in the salad dressing on my salads.

But I’ve also been taking Kyolic garlic capsules for the past month as a way of lowering my BP…And I think it has worked.. But I am relying on a faulty Omron bp meter when I say that…

I have not dwelled on the issue of my BP on this thread but a few comments don’t hurt since BP is a significant subject discussed here.

At rest in bed in the evening and not being excited by anything my meter tells me that my BP is ALWAYS about 110/70, plus minus a few units, and I am using a rather simple wrist cuff model. These constant readings are telling me that that on the one hand the meter is OK and on the other that I am too 🙂 Now sitting in front of the fireplace and chatting with my wife the reading of 125/77 doesn’t feel bad either.

With a blood glucose reading of 5.6 and with my new Ketonix “toy” telling me I am now in a very high ketonic state (probably due to recently having had a dish with a lot of coconut oil – the MCT of this goes directly to the liver to produce ketones!) I feel a little on the “safe side” though I guess there is always a danger with hubris 🙂

When I am getting excited about something unjust in my closer environment and feeling the slightest angina due to this my BP ALWAYS “skyrocket” which in my case will be around 160 and it will take a while, typically little less than an hour to return to a normal state. Heavy philosophical reading is a good medical treat for me in this case in order to relax for sleep.

In comparison during the “war” with my latest cardiologist a few years ago he managed to deliberately (he really worked on this!) raise my BP to 140/80 and then to subscribe drugs for my abnormal state.

I have a friend who for many years has suffered from very high BP’s and he told me once that it was sufficient for him to just think of some very unpleasant event to get the pressure up in the 200 range.

Maybe this is a signal of who are prime candidates for heart disease. Perhaps resting BP is one thing but how easily and frequently we emotionally get into the ‘bad’ ranges is a rather like a post meal glucose test, a more telling testament to how we process stress.

“I have a reputation for scepticism about scientific findings. I do not believe that just because something appears in a peer-reviewed journal, it is a proven fact. I do not believe that only scientists are permitted to challenge other scientists, and then only if they’re scientists of the same kind. I do not believe that “scientific consensus” is evidence, even when it exists. I am highly suspicious of scientists who become activists for this or that political policy.”
Ivo Vegter; 16 November 2017

robert lipp: Thanks for the link. A good read, although I wouldn’t consider Bourlag a hero of any sort. The organic/biodynamic movement and the insights of Alan Savory for regenerating soil while raising animals are the future for feeding gazillions of people.

Amen. Only need to look at adding (?) the Iodine…
D3 from pills, though many wholistic doctors recommend ‘Sol’ as a cheaper & better supplier (you get better sulfur balance from using sunlight, and apparantly CVD is significantly lower in folk getting it naturally.
– Sun-baths, anyone ?

Dr Goran, this is not a race, we hike our own hike and aim to improve slowly or keep up with our own health.

Bill in Oz, the measurements are for you to establish a baseline and figure out what the normal distribution of measurements are. So you would know right away that a 15 difference is outside the “normal expected measurements” and this would indicate you probably read the paper or were upset. You mentioned the cuff pressure, this could make you go higher, I have had the same issue and it causes me to flex my muscle and fight back. This will cause higher readings. So when it does that I cancel it and restart it. Your muscles always need to be relaxed. My wife is a vascular ultrasound tech. she takes readings all over the place, applies pressure with cuffs and measures flow on both sides, a lot can go wrong in the measurments without seeing the actual blood flow. She see’s patients fighting the cuff all the time.

based on the variation in my readings, you are probably near the same and your results are within the expected range.

Hi Steve
Thanks for the comment. As I mentioned yesterday, I stripped all the batteries out of the Omron last night… To clear it’s so called ‘memory’. I then tried it this morning. And got a sensible reading 147/76 with hr 77.

But this evening just now it has reverted to the trying to pressureise the cuff extremely tightly and then a generating reading.

Let me be blun, if a GP pumped the cuff on his BP machine as strong & painfully as this Omron is now doing. I would tell him to stop immediately. And if he did not, leave. He would be incompetent.

So the Omron 7200 is going back where it came from : found wanting. The technology must always be suitable to purpose.

I remember when I recently gave blood at the Blood bank. My bp was tested then and it was OK. I asked the nurse about the device and mentioned that I had an Omron at home.. She raised her eyes high is dismissal & said that the one she was using was a new model $3000 device.

So I will not have a complete record of daily bp’s when I see the GP next Tuesday.. But it’s. long enough series and the impact of garlic capsules is pretty evident.

Bill, three options for you.
1) Buy a cheapie on evilbay, possibly the innards are from the same factory as the Omron…
2) A manual set from the same den of Temptation, make sure it’s got a ‘One-handed’ cuff application loop. AND an analogue gauge.
3) Learn to use it without a stethoscope… simply let out pressure slowwwwwly and watch the points at which the needle starts / stops jumping with the heartbeats…
Spot-On 101% Accuracy is not the most important thing, consistancy & repeatability IS.
I use an Omron wrist unit, and take 3 consecutive readings, The machine will average them out the next time MEM is accessed. Data, Time and Date scribbled into a diary. Works for me.

Back to research. My wife was asking about obesity and diabetes, so I showed her Dr. K’s diabetes cascade and then dug into the web. found a lot of interesting info tying insulin, stress, ageing and cardiac issues, plus backup for Dr. K’s Theories

https://www.sciencedirect.com/science/article/pii/S0092867413001335
Another way to assess the metabolic effects of lipid overload is to acutely infuse lipid emulsions to abruptly raise circulating free fatty acid (FFA) levels, and this maneuver will cause decreased insulin sensitivity within a couple of hours (Boden et al., 2002). Acute lipid infusions and chronic HFD are often viewed as interchangeable models to create lipid overload for studies of metabolic sequelae. However, the mechanisms whereby acute elevations of FFAs and chronic HFD cause decreased insulin sensitivity may not be the same, and evidence has already been published to this effect (Lee et al., 2011).
an interesting result indeed, actually, higher fat reduces insulin…

Insulin keeps the fat in your cells, as Dr. K’s theory suggests:https://www.sciencedaily.com/releases/2016/11/161114143532.htm
Inability to safely store fat increases risk of diabetes, heart disease
A large-scale genetic study has provided strong evidence that the development of insulin resistance — a risk factor for type 2 diabetes and heart attacks and one of the key adverse consequences of obesity — results from the failure to safely store excess fat in the body.
The team also found a link between having a higher number of the 53 genetic risk variants and a severe form of insulin resistance characterized by loss of fat tissue in the arms and legs, known as familial partial lipodystrophy type 1. Patients with lipodystrophy are unable to adequately develop fat tissue when eating too much, and often develop diabetes and heart disease as a result.
Overeating and being physically inactive leads to excess energy, which is stored as fat tissue. This new study suggests that among individuals who have similar levels of eating and physical exercise, those who are less able store the surplus energy as fat in the peripheral body, such as the legs, are at a higher risk of developing insulin resistance, diabetes and cardiovascular disease than those who are able to do so.
Overeating and being physically inactive leads to excess energy, which is stored as fat tissue. This new study suggests that among individuals who have similar levels of eating and physical exercise, those who are less able store the surplus energy as fat in the peripheral body, such as the legs, are at a higher risk of developing insulin resistance, diabetes and cardiovascular disease than those who are able to do so.
“People who carry the genetic risk variants that we’ve identified store less fat in peripheral areas,” says Professor Nick Wareham, also from the MRC Epidemiology Unit. “But this does not mean that they are free from risk of disease, because when their energy intake exceeds expenditure, excess fat is more likely to be stored in unhealthy deposits. The key to avoiding the adverse effects is the maintenance of energy balance by limiting energy intake and maximising expenditure through physical activity.”

There seems to be a genetic component, this is probably the switch which turns off fat storage at a certain time.https://www.ncbi.nlm.nih.gov/pubmed/10320051
Even among young, healthy individuals, there is more than a 10-fold variation in insulin sensitivity; however, taken in combination, all the known modifiers of insulin sensitivity – including obesity and a variety of environmental factors – explain less than one third of this variation. It is possible that genetic factors could account for the bulk of the variance observed, and hence play a major role in the development of impaired insulin sensitivity, ie insulin resistance.

The next finding is huge, high BP induces insulin signaling to the heart and causes heart failure, PLUS Ty1 diabetic mice given insulin, increased their heart failure!!!!! Insulin is the bad actor!https://www.sciencedaily.com/releases/2010/04/100419233109.htm
The team, led by Issei Komuro, has generated data in mice indicating that while persistent high blood pressure induces liver cell resistance to insulin, it enhances insulin signaling in the heart. This excessive chronic insulin signaling exacerbated heart failure caused by high blood pressure. Importantly, although treating type 1 diabetic mice, which produce no insulin, with insulin stabilized their levels of glucose in the blood, it increased heart failure.

https://www.sciencedaily.com/releases/2017/11/171109093827.htm
Low phosphate in the blood is linked to the risk of heart attack and coronary artery disease
“In light of our findings we would suggest that clinicians consider people with low phosphate levels to be at higher cardiovascular risk and assess ways in which this can be reduced for each patient.
Eating during the night is associated with higher risk of heart disease and diabetes, and the body’s 24-hour cycle is to blame,
the immune system plays a surprising role in the aftermath of heart attacks.
When investigators blocked the interferon response, either genetically or with a neutralizing antibody given after the heart attack, there was less inflammation, less heart dysfunction, and improved survival. Specifically, blocking antiviral responses in mice improved survival from 60 percent to over 95 percent. These findings reveal a new potential therapeutic opportunity to prevent heart attacks from progressing to heart failure in patients.
“But we were surprised by the data for the first 365 days after the event: During that time, women were 1.5 times as likely to die as men.
another study aligning with Dr. K: Low Potassium results in calcium buildup!
Low dietary potassium leads to calcified arteries and aortic stiffness, while increased dietary potassium alleviates that in a mouse model, suggesting dietary potassium may protect against heart disease and death from heart disease in humans
Agrees with Dr. K’s phosphate findings, night eating (adding additional insulin) increase heart attacks, immune response to heart attack causes inflammation, Applying antibody suppression increased survival rates from 60-95%.

Other snippets, if you type in the first line of these they should pop up on a google search:
In Murphy’s previous research, she and colleagues found that heart failure was associated with changes in heart muscle cells through altered phosphorylation in the heart muscle protein cardiac troponin I (cTnI), which helps regulate heart contraction. Murphy found that phosphorylation at a specific site on the protein, cTnI Serine 199, in humans was nearly twofold higher in people with heart failure than those without heart failure.

The observation that KLF levels decrease with age and that sustained levels of KLFs can prevent the age-associated loss of blood vessel function is intriguing given that vascular dysfunction contributes significantly to diverse age-associated conditions such as hypertension, heart disease, and dementia” In addition, mice with excess levels of these proteins demonstrated a delay in blood vessel dysfunction associated with aging. The study has major implications for our understanding of aging and age-associated disorders. BLOOD VESSEL FUNCTION ASSOCIATED WITH AGE AND KLF. Is something like this the trigger, I am thinking ageing is associated with some type of trigger that allows a lot of things to begin going wrong.

Using similar methods as in the JAMA study, Arking and his team measured the mitochondrial DNA copy number of 11, 093 participants in the ARIC study. They found that over the course of 20.4 years, 361 participants suffered sudden cardiac death. After adjusting for other risk factors, the researchers determined that participants with relatively low mitochondrial DNA copy numbers were at the highest risk for sudden cardiac death. Levels of mitochondrial DNA have been implicated in many types of cancer as well as overall frailty and mortality. “We know that a lot of diseases correlate with each other, such as diabetes and arthrosclerosis,” says Arking. “It would not surprise me if we found that these markers tie into many phenotypes. Yes, more about ageing and degeneration leading to MI.

Researchers have discovered a previously unrecognized healing capacity of the heart. In a mouse model, they were able to reverse severe heart failure by silencing the activity of Hippo, a signaling pathway that can prevent the regeneration of heart muscle. This brings hope to anyone who has suffered a heart issue.

It’s long been known that heart disease develops later in women than men. But the biological reasons why females have a heart health advantage were unknown (really, it the hormones) Cardiolipins in CLOCK male hearts look like those in humans with heart disease, Martino said. The CLOCK males also had worse cardiac glucose and energy profiles. By contrast, CLOCK female hearts had a healthy cardiolipin profile and better energy.
However, the advantage for CLOCK females was lost when the ovaries were removed, a clear sign that hormones such as estrogen protect the heart even when the circadian mechanism is disturbed, Martino said.

Forced Vital capacity : Increased arterial stiffness is a known predictor of cardiovascular diseases in different populations, including healthy subjects and patients with hypertension, diabetes, or renal disease. A new study examining arterial stiffness in a large population determined that both restrictive spirometry pattern and reduced forced vital capacity (FVC) were associated with a higher risk of arterial stiffness not only in men but also in women. The investigators found that arterial stiffness increased fourfold when FVC decreased.
This could be the result of ageing and KLF’s above.

The researchers reviewed studies involving hundreds of thousands of people and found that antidepressant users had a 33% higher chance of death than non-users. Antidepressant users also had a 14% higher risk of cardiovascular events, such as strokes and heart attacks. What pathways do these affect?

While there is a length range for classifying a healthy telomere, researchers found, for the first time ever, that people with heart failure have shorter telomeres within the cells that make up the heart muscle Researchers were able to measure the telomeres in the samples of patients who had heart disease and those who did not, and group the findings into categories based on patients’ age. They found that in the samples for healthy people, age did not play a role in telomere length, since the telomeres of both young and old healthy individuals were not affected. However, patients with heart failure had shorter telomeres regardless of their age. In comparing diseased and healthy samples, researchers were able to draw a correlation between shorter telomeres and the presence of heart failure. Patients with the shortest telomeres in their cardiac cells also had the most severely decreased cardiac function. The team also found that the cardiomyocytes were the only heart cells affected by the telomere length in disease samples, but the telomere length of other cells within the same diseased heart samples were not different. Another Ageing associated indicator….There are ways to improve your telomeres, Resveratrol and Astralgus are two that I use.

autoimmune diseases significantly increase cardiovascular risk as well as overall mortality. This is particularly pronounced in people suffering rheumatoid arthritis or systemic lupus erythematosus. In addition, it has been seen that inflammatory bowel diseases, such as Crohn’s or ulcerative colitis, increase the risk of stroke and death through any cause. Yes, my fatyer had bad arthritis, this agrees with other papers above. The immune system plays a part, maybe in the ageing effect, or inflammation?

“People who consumed more than 13.7 grams of salt daily had a two times higher risk of heart failure compared to those consuming less than 6.8 grams,” another J-curve effect, that’s a lot of salt, more than 6 teaspoons.

High physical fitness is known to be related to enhanced blood vessel dilation and blood flow (endothelial function) in aging men. However, for women, endothelial function and the effect of exercise may be related more to menopausal status than fitness. Perimenopausal women had higher FMD, and their blood vessels dilated faster — indicating better endothelial function — compared with postmenopausal women, when both aerobic fitness groups were combined. Before 30 minutes of treadmill exercise, low and highly fit women had similar FMD. However, after exercise, low-fit women had higher FMD than highly fit women.
women beat men again in heart issues, until menopause.

Researchers know that changes in gene expression occur during cardiomyopathy, but it remains unclear whether these changes are due to declining heart function or whether these changes are part of the progression to heart failure. A better understanding of the role transcription co-factors — proteins that are key to the regulation and expression of genes — could provide important clues into how heart failure develops. Researchers show how this DNA variant enhances the activity of a gene called endothelin-1, which is known to promote vasoconstriction and hardening of the arteries. The main value of our research is the pinpointing of the importance of endothelin-1 and blood vessel constriction to multiple vascular diseases,” says senior author Sekar Kathiresan, a cardiologist at the Broad Institute of MIT and Harvard University. “We also show how to identify a core gene for multiple diseases through genome editing in cells.” Past studies have shown that ET-1 is the most potent, longest-lasting vasoconstrictor in humans, and it promotes the development of plaques inside the arteries. Because rs9349379 increases ET-1 production, this genetic variant could explain the co-occurrence of coronary artery disease with migraine headache, cervical artery dissection, fibromuscular dysplasia, and hypertension. These can all be age related too.

This study reinforces previous research investigating the link between depression, heart disease, and increased risks of death. It’s already been shown that people with coronary artery disease don’t live as long as their peers who don’t have heart disease. And while life expectancy has increased with better therapies, surgeries, and more aggressive treatment of identified risk factors, depression has come under increasing scrutiny as a risk factor that could make a difference, if properly treated. Research has shown that the relationship is bi-directional: Depression may result in worse outcomes for people with heart disease, while the presence of heart disease may increase the likelihood that someone will develop depression.Those with depression were significantly younger and more often female, diabetic, previously diagnosed with depression, and less likely to have presented with a heart attack compared to those who didn’t have depression. Heart problems cause depression, or depression causes heart problems?

The researchers analysed the associations between a first infection with sepsis or pneumonia that resulted in hospital admission with subsequent cardiovascular disease risk at pre-specified time intervals post-infection (0-1, >1-2, >2-3, >3-4, >4-5, and 5+ years after hospital admission for the infection). During the follow-up period, a total of 46 754 men (19.7%) had a first diagnosis of cardiovascular disease. There were 9 987 hospital admissions for pneumonia or sepsis among 8 534 men who received these diagnoses. The researchers found that infection was associated with a 6.33-fold raised risk of cardiovascular disease during the first year after the infection. In the second and third years following an infection, cardiovascular disease risk remained raised by 2.47 and 2.12 times. Risk decreased with time but was still raised for at least five years after the infection by nearly two-fold (hazard ratio 1.87). “Our results indicate that the risk of cardiovascular disease, including coronary heart disease and stroke, was increased after hospital admission for sepsis or pneumonia,” said lead author Dr Cecilia Bergh, an affiliated researcher at Örebro University. “The risk remained notably raised for three years after infection and was still nearly two-fold after five years.” infection was associated with the highest magnitude of cardiovascular disease risk in the first three years post-infection.
Heart disease associated with heightened immune response……seems that there may be some damage from the initial disease?

Plant-based diets are recommended to reduce the risk of heart disease; however, some plant-based diets are associated with a higher risk of heart disease, according to a new study. During follow-up, 8,631 participants developed coronary heart disease. Overall, adherence to a plant-based diet was associated with a lower risk of heart disease. A higher intake of a more healthful plant-based diet — one rich in whole grains, fruits, vegetables, etc. — was associated with a substantially lower risk of heart disease. However, a plant-based diet that emphasized less healthy plant foods like sweetened beverages, refined grains, potatoes and sweets had the opposite effect. DUH, carbs raise heart risk!!! (from increase in insulin, that affects everything in a bad way)

In patients and animal models, who are both older and obese, Bagi has found a key dynamic in the dysfunction is an enzyme called ADAM17, which is involved in a huge variety of functions like releasing growth factors as we develop, but also implicated in diseases from Alzheimer’s to arthritis. ADAM17 levels increase in obesity while levels of its natural inhibitor, the protein caveolin-1, decrease with age, enabling the perfect storm. ADAM17 was discovered 20 years ago for its ability to cut and release previously inactive tumor necrosis factor, or TNF, from the cell membrane. TNF is a multifunctional protein, or cytokine, that gets its name from its skill at killing tumors and is a major promoter of inflammation that also directly impacts the function of the endothelial cells that line blood vessels.The MCG scientist found that ADAM17 cleaves TNF from fat, releasing it into the bloodstream where it preferentially targets the heart. The bottom line: the walls of the hair-sized microvasculature become thicker, less elastic, less able to dilate and to properly sustain the heart. His research team found ADAM17 highly expressed in fat and even higher in the blood vessels of aged human fat.. The protein level was increased in younger mice on a high-fat diet, but the significant increase in its activity came with age and fat….Another ageing switch? Also looks like insulin causes ageing as fat people need insulin to stay fat!

A total of 519,880 patients were followed from 2003-2013, during this period there were 23,233 cases of shingles. The final cohort of 23,213 was matched with the same number of shingles-free patients to serve as control subjects. Patients with shingles were more likely to be female and common risk factors for stroke and heart attack, such as old age, high blood pressure, diabetes and high cholesterol, were also more commonly seen in these patients. However, this group was also less likely to smoke, have a lower alcohol intake, more exercise and be part of a higher socioeconomic class. Shingles was found to raise the risk of a composite of cardiovascular events including heart attack and stroke by 41 percent, the risk of stroke by 35 percent and the risk of heart attack by 59 percent. The risk for stroke was highest in those under 40 years old, a relatively younger population with fewer risks for atherosclerosis. The risks of both stroke and heart attack were highest the first year after the onset of shingles and decreased with time. However, these risks were evenly distributed in the shingles-free group. Another immune system influence of future problems…

The recently published study was conducted using a large animal model, which is relevant for humans. The researchers were able to show that thousands of genes are involved in a heart attack: the heart attack changes the expression of nearly 9,000 genes in the heart but also 900 in the liver and around 350 in the spleen tissue within 24 hours of the infarction. At the same time, they were able to ascribe a major role to the transcription factor Klf4 (a protein that is important for activating many other genes) — this “large animal insight” was also confirmed by histological tests performed on human autopsy material. The central message of this paper: “Myocardial ischaemia, that is to say a heart attack, does not end with the damaged heart muscle. Heart attack affects several systems, or is there other systemic issues involved? This definitely changes what you want to treat after MI.

The loss of a loved one, a dispute with your neighbour, infections or a fall – mental and physical stress can be triggers of a broken heart (broken heart syndrome). What is more, physical stress seems to be more dangerous than emotional stress, a study shows. As a result of the DZHK study, the trigger “physical stress” is gaining focus. The study was able to confirm that infections, accidents or similar, i.e., everything that puts the body under stress, are often the triggers of a Takotsubo cardiomyopathy in men. By contrast, in women, it is emotional stress. Now, new findings show that physical stress as a trigger considerably worsens the prognosis in both women and men…Stress, different types are worse, Men and women different here.

Ty 2 diabetics measured for copeptin and followed for 7 years. Once the data were adjusted for other influencing factors, the results indicated that patients were more than twice as likely to experience heart attack or stroke for every 1 pmol/L increase in blood copeptin levels. what causes this increase, i need to study this one more.

The risk of having a heart attack is 17 times higher in the seven days following a respiratory infection, University of Sydney research has found. “The data showed that the increased risk of a heart attack isn’t necessarily just at the beginning of respiratory symptoms, it peaks in the first 7 days and gradually reduces but remains elevated for one month.” The study was an investigation of 578 consecutive patients with heart attack due to a coronary artery blockage, who provided information on recent and usual occurrence of symptoms of respiratory infection. Seventeen per cent of patients reported symptoms of respiratory infection within 7 days of the heart attack, and 21 per cent within 31 days. Lead author Dr Lorcan Ruane, who conducted the work at University of Sydney said: “For those participants who reported milder upper respiratory tract infection symptoms the risk increase was less, but was still elevated by 13 fold.” I am guessing that these infections put a lot of stress on the heart, also inflammation and immune response that may interact. same as other findings above.

A new study finds that dietary nitrate — a compound that dilates blood vessels to decrease blood pressure — may reduce overstimulation of the sympathetic nervous system that occurs with heart disease.

Unemployment associated with 50% higher risk of death in heart failure patients Not being employed linked with greater likelihood of death than history of diabetes or stroke. Broken heart beats diabetes and stroke!

I quit, I have 10 more pages of heart associated findings from the last year of the sciencdirect articles. The themes should be clear, Stress, Disease, Ageing, Immune system, Broken Heart, Insulin, etc. All big actors. Based on this I am changing my intermittent fasting by eating only between 12-8PM, and only one large meal if possible, with one or two 100% fat snack meals if needed. this should eliminate insulin spikes, and only have one large insulin increase during the day and stretch out the meal longer. The ageing component can probably be held off with Resveratrol, minimize Insulin activity and Vitamin C to keep the arteries young. But there seems to be a switch, maybe one of the ones mentioned or something else that affects these. Maybe there are other ways to supplement to get around the ageing issue

Very thorough. A lot of stuff in here of great interest. I am going to suggest you break it up into more digestible bits, of possible. When I have finished writing my latest book I will have a bit more time to co-ordinate the input of those on this blog who have much to share.

“Plant-based diets are recommended to reduce the risk of heart disease; however, some plant-based diets are associated with a higher risk of heart disease, according to a new study. During follow-up, 8,631 participants developed coronary heart disease. Overall, adherence to a plant-based diet was associated with a lower risk of heart disease. A higher intake of a more healthful plant-based diet — one rich in whole grains, fruits, vegetables, etc. — was associated with a substantially lower risk of heart disease. However, a plant-based diet that emphasized less healthy plant foods like sweetened beverages, refined grains, potatoes and sweets had the opposite effect. DUH, carbs raise heart risk!!! (from increase in insulin, that affects everything in a bad way)”

The LCHF movement has had the solution for ages… And we know it works, due to the push-back from The Establishment, specifically in South Africa where the Dietitians tried to crucify Emeritus Prof. Noakes…..and the Aussie ones managed to nobble Dr Gary Fettke from EVER giving that or ANY dietary advice, even if/when it becomes official practice…
It’s about smoothing and keeping Insulin levels stable and low.

With respect to the first citation, Ivor Cummins, Prof Noakes, Fettke LCHF et al, seem to suggest that Insulin Resistance / over-stimulation (high carb diet) is what drives obesity… not the other way around which is the current ‘Medical Establishment’ group-think

Insulin resistance is a later stage phenomenon. The process start with over-secretion of insulin, this drives obesity and the rest follows. However, the main trigger for diabetes is not obesity, it is the inability to store fat. A very simplistic model has been created which is wrong.

You might have something there… My first reaction was…?!!! – I store fat VERY well… too well, around the midriff, – so Kendrick must be rong.. but on reflection, even at my largest, it is all ‘trunk’ fat, the arms, legs, neck/head, back of hands-knuckles, never looked ‘fat’ or ‘too well nourished’…. and the spare tyre was mounted on a solid (visceral) foundation…..
Darn! the Scotchman is Right. Again.
🙂
in the end, the solution is still the same… stop eating stuff wot aggro’s the insulin !

Here it might be appropriate for me to remind interested, asking the question of how blood sugar is regulated i diabetic people through interactions between the beta insulin producing cells in the pancreas and the adjacent alfa cells producing the counteracting hormone glucagon, of a lecture about this subject which turned my world upside down. It was the prize lecture of professor Roger Unger which i am now again linking to for benefit of “newcomers”. i would appreciate all serious comments on this subject since I think this subject has been so neglected and misunderstood by the establishment.

I apologize for the huge post. I took vascular ultrasound book chapters before and boiled them down. I will do that with the rest of my data and try to categorize better. Yes, there are a lot of papers that agree on several key characteristics, as Dr. K has pointed out and the papers seem to agree, there is a diabetic fat switch, that turns on depending on your genetics and/or the amount of overeating and possibly ageing. This is required to answer all diabetic cases via pure logic. It is the same logic used to say that ageing results in several bad actors creating a storm to cause MI, Cardio disease, cancer and many others. The switch in women is hormonal, tied to the reproduction. This switch is everywhere in the animal kingdom, so why wouldn’t it be in humans too? so genetics, diseases, ageing, hormones, dysfunctional hardware (collaterals, heart, valves, heart muscle, electrical, biochemical, mechanical), etc. (not in any special order) Also, the main savior is FITNESS LEVEL, then all the others which have a confluence of inputs. INSULIN, Disease, Psychology, Physiology, Sociology. not all hard sciences at all.

The best answer for longer disease free life is Exercise/fitness level, which is nearly instantaneous and clearly shows the biggest improvements no matter what age.

You may be right, but it might be called learning from experience, or just learning. Is nobody allowed to change their recommendations? Conflict of interest? Arte you saying that anyone who recommends anything, then sells it necessarily has a conflict of interest? People are entitled to earn something to support their output. Even writing a book could come under the banner “conflict of interest”. I wrote a book, I suggest you don’t buy it or I will be accused of a conflict of interest”.

OK, lets dig deeper into one large factor that was in the findings, mainly that getting a nasty respiratory infection increased MI by 17X, within the first week! even a light upper respiratory incident raises the risk by 13X, This is a very strong cause and effect.

GOUT of the Heart? Well yes, Gout doubles MI and stroke risk!
New research published in the Rheumatology journal has found that having gout doubles the risk of heart attack and stroke. The research tracked the health of more than 205,000 gout patients using data spanning five decades to determine links between gout and heart attack and stroke.

Now what happens to the Sympathetic Nervous System with respect to the immune system?
Hit this paper tying stroke to Pneumonia as well. Nearly all their conclusions say that the severity of the stroke results in the severity of the pneumonia, but is this part of the immune response, or is this backwards, the stroke is caused by Pneumonia, which then shows up after it has caused the stroke?https://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-014-0213-4
but the best part is:
The immune system response and inflammation play a key role in brain injury during and after a stroke. The acute immune response is responsible for secondary brain tissue damage immediately after the stroke, followed by immunosuppression due to sympathetic nervous system activation. The latter increases risk of infection complications, such as pneumonia. The pneumonia-related inflammatory state can release a bystander autoimmune response against central nervous system antigens, thereby initiating a vicious circle.

So now I am thinking that we as we age, our immune systems degrade so that disease is really the initiator of the heart attack or stroke. and with 17X increase after a huge immune system requirement, I hit upon a general paper on the body’s response to pain/stress that sort of hits the mark on how many of our biological systems are affected.https://www.nursingtimes.net/clinical-archive/pain-management/understanding-the-physiological-effects-of-unrelieved-pain/205262.article
Pain/ Stress can induce the sympathetic nervous system into action, so both stress can induce it and pain can induce it. So it is induced pretty much 100% of all MI cases, either in front of, and producing the MI, or as a result of the MI?

Am I on the right track? does this answer most cases of MI? It would seem that low Vitamin C levels can be degraded rapidly due to fighting endotoxin attacks, resulting in uric acid in the heart tissue. Gout is extremely painful, resulting in damaged tissue. This causes pain, which drives the nervous and other systems into quick action, but there is dysfunction during pain that can make things worse? You bet, because pain can increase glucagon:

Glucagon is a polypeptide produced by the pancreatic islets in the upper gastrointestinal tract. The stress response causes glucagon levels to increase, so elevating the metabolic rate and lowering insulin levels. The result is hyperglycaemia and impaired glucose tolerance, together with carbohydrate, protein and fat destruction (Park et al, 2002). An increase in glucagon and catecholamines stimulates glycogenolysis and the release of glucose from the liver into the circulation for immediate use by critical organs, such as the brain.
Catecholamines are indicated in a lot of MI issues.

Another study found: This became evident to researchers from New Zealand’s Massey University. In their 2015 review of recent research on lipopolysaccharides (endotoxin), they found that even low levels of circulating lipopolysaccharides were problematic. They found continuous lipopolysaccharide circulation – even at low levels – were linked to increased incidence of insulin resistance, type-2 diabetes, atherosclerosis and cardiovascular disease

WOW! endotoxins drive a host of bad things, even at low levels. Lots of things produce these , candida, pneumonia, staph and many others. Could MI really be the result of catching a bad disease? well yes: The researchers stated in their conclusion:
“Lipopolysaccharides responsiveness in patients with chronic heart failure is an independent predictor of death.” Well yes, we saw that MI is 17X higher as a result!http://choosevibranthealth.com/bacteria-endotoxin-leakage-heart-failure/

So I am thinking that as we age, a lot of our problems are stemming from a worn down immune system, either long term endotoxins cause increased cholesterol or other immune responses resulting in inflammation, arterial issues and the resulting plaques, which also could be part of the reduction in Vitamin C due to the toxins. then as we get overloaded by endotoxins, which wears on us further causing increased stress to our systems, larger and larger immune responses, which included cholesterol, insulin, glucagon, cytokines and several responses. It also results in reducing the heart tissue effectiveness, even causing gout in the heart tissue. then the pain of the tissue response, or the full blown disease overwhelms the system and involves the sympathetic nervous system which kicks into gear and brings in everything. Then as everything is brought on line, the stress in the worn down system induces full blown MI.

This can explain both the latent types of issues that bloom into MI and fast onset of MI.

Several effects from stress can bring this on by suppressing the immune system, invoking some of the stress response systems, over riding the parasympathetic system, etc. am I on the right track here? Any counter points?

Steve, Thanks for that long comment with detailed notes about the impact of infectious diseases on stroke and heart attack rates – especially in us older folk…

So maintaining a healthy immune system is very important.. And a healthy immune system depends a lot of the thymus ( located in the front at the top of the chest ). The thymus frequently shrinks and losses functionality as we age…Leading to a compromised immune system…

And some anti aging medical experts have in the past prescribed HGH as this hormone regenerates the thymus in older folks like us…Certainly the anti-aging doctor i saw here in Oz for a few years, strongly recommended this for this purpose among others….

However it is an expensive option..I wonder if there are other ways of regenerating the thymus ?

Maybe it’s the medicine prescribed for the disease that causes the problem.

I am convinced when a single drug is prescribed, the doctor probably knows what to anticipate. When two drugs are prescribed, uncertainty prevails. When three drugs are prescribed, a doctor hasn’t the foggiest notion how a patient will react. When four drugs are prescribed, God doesn’t know what might ensue…

At present poly-pharmacy is the fate of the elderly. By age 65 multimorbidity is the new normal, as are visits to numerous specialists. This inevitably results in a stash of drugs. In my experience ten or more medications are the rule.

[After my father developed disabling vertigo from eye drops] I insisted that patients with new symptoms bring in all their brand and generic drugs, including health supplements, vitamins, minerals, eyedrops, ointments, and lotions. At times I found duplicates as well as medications I had never been informed about. Many times it enabled me to identify the hitherto elusive causes for inexplicably bizarre symptoms…

A Cambridge University study on polypharmacy reveals:
– Almost half of over-65s in England are taking at least five different drugs a day
– Some were on up to 23 tablets every day.
– the proportion taking no pills at all is just seven per cent.
– Heart disease pills, such as statins, accounted for nearly half the medicines taken.
– taking up to five a day increased the dangers by an estimated 47 per cent
– those taking six medicines or more a day were nearly three times as likely to die prematurely (Spanish study)http://www.telegraph.co.uk/news/2017/11/15/half-over-65s-take-least-five-drugs-day/

Martin re prescription drugs:https://ethics.harvard.edu/blog/new-prescription-drugs-major-health-risk-few-offsetting-advantages
“Few know that systematic reviews of hospital charts found that even properly prescribed drugs (aside from misprescribing, overdosing, or self-prescribing) cause about 1.9 million hospitalizations a year. Another 840,000 hospitalized patients are given drugs that cause serious adverse reactions for a total of 2.74 million serious adverse drug reactions. About 128,000 people die from drugs prescribed to them. This makes prescription drugs a major health risk, ranking 4th with stroke as a leading cause of death.”

Thank you for sharing your broad brush, as well as specific approach to MI with us.

In my own experience I can relate to very much of what you say.

E.g., I had a very nasty flu one month before I was hit 1999.

Talking the benefits of exercise was it my decision to use the bike to get to work (12 km) every day in rain- and snowstorms all year around that made me “thrive” despite my severe CVD? With time I logged about 20.000 km on my bike computer. But as i usually admit almost everyone, young and old, passed me on the bike track.

Or was it that I quite all PUFAS and all sweet stuff that made me survive? Or was it actually that I refused CABG and all medication although garlic may be considered as a medical herb?

I love your reference to the complexity of our physiology and especially to the interactions between all our thousand and thousands of proteins. This insight once struck me as a hammer when starting reading the “Microbiology of the CELL”. This interaction fact also stresses to me the importance of never turning categoric or dogmatic. (Medicine is unfortunately full of this “religious” abuse of science to my opinion and that is why Big Pharma “criminality” can continue.)

With Karl Popper ( and Schopenhauer) I can only agree that one can only make a concept more appealing and probable by corroboration but never true as my favorit philosopher Xenophanes stated already 2.500 years ago.

Going back to high blood pressure..
This weekend an article was publsihed here in Oz, about how a high salt diet can impact the microbiome and thus leading to hypertension..
Apparently a high salt diet tends to reduce lactobacilus species in the gut…which are protective against hypertension..

What is “high salt”? We need sodium. IF It leads to high blood pressure, drink more water and lower the pressure. What is “high blood pressure”? Blood pressure is a dynamic function which changes according circumstances

Bill in Oz: Thanks for the link. There is too little information in this article to make it useful, though. What do they consider “high salt,” and what do they consider “normal salt”? Good to know that excess salt reduces Lactobacilli species and increases inflammatory markers, but what is excess salt? I’ll stick with what I’ve learned in “The Salt Fix.” For those of us who eat little or no factory food, making certain we have sufficient salt in out diet is of greater importance, I think, than worrying about limiting it. Dr. DiNicolantonio talks about the “salt set point,” which, for most people is 3-4g/day, more than our mommy government’s highest recommended amount of 2.3g/day.

Without reading the salt article, I am deeply suspicious of a paper that offers a complicated reason why high salt might raise hypertension, when the whole point is that actual studies demonstrate that it makes no significant difference to people’s BP!

the idea that salt would raise would raise BP, was based on a naive argument based on osmotic pressure, however BP is actually controlled by a feedback loop. Nevertheless the idea stuck because at the time there were no BP lowering medicines available.

Another example of the Lessons from Fairy Tales being disregarded, to our peril.
Or, ‘Goldilocks’ … and the J – Curve. Some where between 2 and 6 g (max range) per day, as per the individual.
Not only, but the source matters, Himalayan Pink – mineralised – salt being highly regarded, down to Free-Flowing white Factory fodder being the least, with various Sea + deep-mined salts between the two.
The other Inconvenient Factor is… Not everyone responds in the same way to the same extent. ‘Naturally Hypertensives’ need less salt to bump up BP, whereas some annoying individuals partake of enough to rust a battleship !

Its not that complicated. The gut has vast connections with the brain and therefore whatever happens down there..is going to be ‘known’ Up Here.
All off the Ancient Physicians cited the gut/stomach/digestive system as being a foundation to ‘Health’.
Today, modern Shamans are documenting the differences in gut population species between western and other races, robust and sickly, healthy and afflicted.
Processed and ‘modern’ (read GMO) diets tend towards the unfortunate end, whereas fresh, ‘Real’ and wide-variety intakes are associated with ‘protective’ outcomes.
It ain’t Rocket Science !

Not sure on salt content of shop bought sauerkraut but I make my own. I have reduced from a ‘recommended’ brine level of 2-2.5% salt, to weight of cabbage, to 1.5%. You can also make it salt free, I’ve not tried this yet. Any veg not just cabbage can be fermented. Currently I have 80 cloves of garlic fermenting with ginger & spices. The smell is absolutely mouthwatering!

Paul Sturgeon: My thought, too, although I’m going to add turmeric to the garlic and ginger, since the roots are available here at the Indian store. My task for today. I don’t skimp on salt in my ferments. Sodium and chloride are two of the most important minerals, and it is hard to eat too much.

Gary, it would be great if you could provide some evidence to support your comment….

Lacto bacilous bacteria are usually found in fermented dairy foods like yogurt and sour cream etc. ( the name Lacto = milk ) So I am surprised at you sating they are also the basis of saurkraut fermentation

Bill in Oz: When I ferment I use whey. Although this is not essential, I think it speeds the process and helps prevent failure. It is my understanding that the Lactobacilli in the whey (and in its absence from the presence of the bacteria on the leaves themselves) which are the primary agent of fermentation. Excellent resource: Any of Sandor Ellix Katz’s books, “The Art of Fermentation” being the most comprehensive.

And some anti aging medical experts have in the past prescribed HGH as this hormone regenerates the thymus in older folks like us…Certainly the anti-aging doctor i saw here in Oz for a few years, strongly recommended this for this purpose among others….

However it is an expensive option..I wonder if there are other ways of regenerating the thymus ?

Celebrities and others with more money than sense seeking the elixir of youth pay small fortunes for regular HGH injections. What they don’t appear to know is that anyone can boost their HGH levels by hundreds of %, totally naturally, for free and far more effectively than any injection. Lean muscle mass, bone density, strength, skin thickness and tone etc all improve whilst insulin levels go way down.

And the method? Fasting!
Our bodies are designed with all these healing and regeneration abilities already built in.
Quoting Hippocrates and Plutarch, ‘Instead of using medicine, rather fast a day’.

Whooa, I am sorry about this as it throws a huge wrench into the cause of MI/stroke. the more I dig into the immune system, the immune response, the effects on the heart, vascular system, etc. the more this is looking like the root cause: there are thousands upon thousands of papers showing that everything that seems to affect MI is affected greatly by infections from bacteria/fungus and maybe virus and various types of immune responses, functional and dysfunctional

Our immune systems are greatly affected by EVERYTHING that increases MI risk:
Sickle Cell Anemia
Stress, anxiety, depression
Diabetes
Age
Hormones
Menopause
Cold weather
Smoking
and of course all those genetic and immune system diseases which have high rates of MI.
I would guess the Sympathetic Nervous System is affected by these agents as well, for sure menningal types.

New Infections or latent infections can come on and initiate all the symptoms and issues associated with MI/CVD pretty quickly. Many pathogens have been found inside plaques and heart tissue of MI. Several pathogens attack heart tissue directly, several pathogens have been found inside infected parts of the heart, valve replacements get infected by pathogens. Cholesterol is part of one of the immune responses, such that it would be found inside the plaque defending against invaders. Infectious agents could easily be the root cause for the entire cardio vascular disease issue.

Everything is pointing in this direction. Remember H Pylori is the infectious agent for what was thought to be stress for stomach ulcers? I believe that certain or multiple infection agents are the cause of MI and all associated symptoms. Just search on your symptom or disease and immune suppression or immune response. We saw that Vitamin C suppressed the immune response by inactivating bacterial toxins. Positive Attitude is found in all Centenarians along with high cholesterol. everything is pointing towards an optimal immune system and the immune response as effective to guard against all diseases and this includes CVD and cancer!

So I am finding that the root cause of MI and cancer may even be related. cytomegalovirus is one of the suspects for CVD and this is implicated in Glioma. When treated for CMV, glioma patients increase survival rate by 3-5X.

The evidence is pointing me in this direction. it is a pretty large area that is experiencing a lot of research. Catching these diseases may also flip genes, even genes that could affect your offspring, maybe even to evolve better collaterals. Most GMO methods involve the use of virus to cut and splice genes, this could explain a lot of other genetic features or issues surrounding CVD.

So there it is. I think the evidence is not perfect, but there is a lot of research pointing clearly to infectious agents as driving the entire CVD train. From genetics, All higher CVD factors that I am investigating, it fits all of the symptoms and problems associated with MI, it fits several etiologies of CVD (if not all of them).

Steve, I am intrigued about mitochondria and their contribution to health. Basically HEALTHY MITOCHONDRIA = HEALTHY IMMUNE SYSTEM is a possibility. Reduced ATP = reduced viability. Dug up a few quick references.

http://www.mitoaction.org/blog/immune-function-and-mitochondrial-disease
“The immune system is closely linked to mitochondrial function because all immune responses, both innate as well as adaptive, depend on energy metabolism to function. Current research supports the role of mitochondrial function in viral and bacterial immunity as well as T-cell memory and function.”

Re Immune Response etc.
Dentists Deny, but some Cardiologists take a dim view of Root-Canals, as being a ‘possible’ (less then 101% done?) supplier of systemic bacteria and toxins, and I was given very clear advice to get my dental/gun health into a perfect state, BEFORE I had my CABGs…
I’ve read that autopsy results of plaque examination often reveals the presence of bacteria normally found in diseased gums and rotted teeth.
Chronically unwell people have different ratios and gut – ‘bug’ populations from the chronically (!) Healthy. . .
– join the dots.

That the bacteria found in he gums and ‘rot’ canals are particularly damaging to the arteries if/ when conditions are right. Think a ‘reservoir’ of opportunistic evil …
My parents’ generation were familiar with significant health benefits that often followed teeth extraction and fitting false fangs . Cardio surgeons at a large hospital here require “perfect” oral hygiene before certain surgeries.
There’s a lesson there.

White blood cells are connected to the immune system, so you might have something there.

As part of the federally supported Women’s Health Initiative, investigators at medical centers all over the United States collected information on 72,242 postmenopausal women 50 to 79 years old. All were free of heart and blood vessel disease at the start of the study. During six years of follow-up, 1,626 heart disease deaths, heart attacks, and strokes occurred. Women with more than 6.7 billion white cells per liter of blood had more than double the risk of fatal heart disease than women with 4.7 billion cells per liter or lower. A count of 6.7 is considered to be in the upper range of normal, so what is “normal” may have to be redefined.

Women with the highest counts had a 40 percent higher risk of nonfatal heart attack, 46 percent higher risk of stroke, and a 50 percent greater risk of death from all causes.

But we might have a chicken and egg situation here. Plaque build-up leads to increased white blood cell count to clear the plaque; the increased count is not necessarily due to infection.

Also, your immune system needs to be stressed. According to the ‘hygiene hypothesis’, too sterile an environment leads to problems. So you need to be in the infection ‘Goldilocks zone’ — not too much, not too little.

If infections are the rot cause of heart disease how come those Bolivian Indians have no heart disease and yet their main cause of death and general health threat are infections. I suspect infections can be a trigger for heart attacks but we have to go further downstream to find a root cause among the general population.

Are they the ‘Indians’ who have very low salt intake leading to low BP ? Or was it low cholesterol ?
– IF they’re the ones I[m thinking of (sorry, memory is shot since CABG x 5 last year) then they die of (skin-wounds) ‘infections’. – Too low SODIUM in their system, which is the first line of automatic defence.
So, “no” heart disease in their lifetime… they don’t live long enough to test the theory, average age is under 40
– From a youtube video by Dr Aseem Malhotra, if my remnant-memory is working….

James DownUnder: The Yanomami of Venezuela have low sodium intake, low BP, and short lives. Probably a low rate of CVD, too. Perhaps the only good news about their health. Lots of warfare, as the population, despite all of this, continues to grow, and new settlements established, as finite resources limit the size of established communities.

If you don’t eat enough salt, the kidneys keep the blood pressure by activating the renin/angiotensin system. This constricts blood vessels throughout the body and keeps the BP up. However angiotensin II is relatively toxic to endothelial cells and disrupts NO synthesis. Personally I would recommend avoiding anything that triggers the renin/angiotensin system.

Discovery of the unexpected intercellular messenger and transmitter nitric oxide (NO) was the highlight of highly competitive investigations to identify the nature of endothelium-derived relaxing factor. This labile, gaseous molecule plays obligatory roles as one of the most promising physiological regulators in cardiovascular function. Its biological effects include vasodilatation, increased regional blood perfusion, lowering of systemic blood pressure, and antithrombosis and anti-atherosclerosis effects, which counteract the vascular actions of endogenous angiotensin (ANG) II. Interactions of these vasodilator and vasoconstrictor substances in the circulation have been a topic that has drawn the special interest of both cardiovascular researchers and clinicians. Therapeutic agents that inhibit the synthesis and action of ANG II are widely accepted to be essential in treating circulatory and metabolic dysfunctions, including hypertension and diabetes mellitus, and increased availability of NO is one of the most important pharmacological mechanisms underlying their beneficial actions. https://www.ncbi.nlm.nih.gov/pubmed/17329548

Sorry james this is inaccurate, they were scanned for heart disease as opposed to logged as death from heart disease. As we have seen heart disease can show up in 20 year olds on a western diet so 40 year olds, and no one was less than 40 in the Bolivian study, would have some signs of heart disease all things being equal but the Bolivian tribe checked had virtually none.

Salt has always been necessary for life – its importance was such that the Romans paid their troops with salt. I’ve long wondered why potassium, which must be balanced with salt, has been hardly mentioned in history.

Steve,
Dr. David Grimes has pointed out that if you look at the graph of heart disease in the US and UK, rising to a maximum in the ’60s then falling away, it looks like the curve of an epidemic, therefore, on the well-known scientific principle of “if it walks like a duck and it talks like a duck, …” he has concluded there was some biological infectious agent responsible for the epidemic.

Dr. Kendrick disagrees, so I won’t provide a link to Dr. Grimes’s website, but you can find it easily enough if you are interested.

Please provide a link (I have seen his graph and have a few discussion with Dr Grimes). I would hate to think people are not looking at alternative ideas because I might disagree with them. My view of Dr Grimes graph is that it is not accurate. Also, if an infectious agent were responsible for the ‘epidemic’ of heart disease then we should see the same, or very similar pattern, around the world, within the same sort of time period. Also, the same pattern within various countries. We see nothing of the sort.

Martin Back: Micro-organisms inhabit the same territory as all the rest of us. Most of them are simply unknown to science. Heart disease incidence simply does not fit what we know about how infectious diseases cause epidemics. In individual cases, they (such as bacteria which can cause gum disease) can indeed lead to CVD, but as a main cause, there is far too much contradictory evidence.

Gary,
There is no satisfactory explanation for the “epidemic” of heart disease that peaked in the 1960s, IMO. I am happy to believe that on top of the usual factors: smoking, stress, diet etc, there was a biological plague which has now passed or to which we have become immune.

Actually, I am coming round to the idea that it was fashionable to have heart attacks in those days, and that’s why they became so common. From The Divided Mind by John E. Sarno M.D.:

Edward Shorter, a medical historian, concluded from his study of the medical literature that the incidence of a psychogenic disorder grows to epidemic proportions when the disorder is in vogue

Dr. Kendrick has fingered stress as a major cause of heart disease. Since stress is a function of how our mind interprets events, he is effectively saying that heart disease is a psychogenic disorder. Not all heart disease; just that proportion which is stress-related.

My parents’ generation was the one most afflicted by heart disease. They lived through the very stressful years of the Depression and WWII, only to die during the time the West was in its golden years — growing rapidly wealthier, and dominating the world militarily. Unless stress has a delayed action, I don’t see how stress per se could be a cause of CVD. But that was also the time that hard-driving Type A executives were heroic figures, and they were dying of heart disease in their droves. It became the fashionable disease to have.

Nowadays they all ride bicycles dressed in Lycra with silly helmets. The glory days of heart disease are over.

Martin
Way off topic, but about silly helmets, I have a friend who came off his bike at about 25 mph, slid across the road into a stone church wall which he hit with his head. Luckily he was wearing a helmet, sillŷ or otherwise, or my story would have started, I HAD a friend

So there it is. I think the evidence is not perfect, but there is a lot of research pointing clearly to infectious agents as driving the entire CVD train. From genetics, All higher CVD factors that I am investigating, it fits all of the symptoms and problems associated with MI, it fits several etiologies of CVD (if not all of them).

Any thoughts, any counter arguments? any other conclusions?

But then how would you explain adjacent countries, one with a high rate of CVD the other with low rates? Or even population groups within countries, some with CVD others without? Infectious agents should show spread from source, not skipping countries / popluations apparently at random.

http://holistic-pharmacist.com/articles/the-ph-connection-colds-flu/
There are some alkaline powerfoods such as lemon, apple cider vinegar, aloe vera juice, chlorella, spirulina and other green-food powders, as well as citrate minerals of potassium, magnesium and calcium, that when added to alkaline water or spring water will help balance the body’s pH.

Andy S: Reading the first reference, I stopped at: “Viruses are extremely small parasitic life forms, the smallest living things on Earth.” As far as I know, virologists do not consider them to be living things at all, but are produced by virtually all life forms in the course of their daily lives. Gazillions of them. Endogenous viruses are clearly essential in metabolic processes, otherwise, why would cells bother making them? I suppose it is well established that exogenous viruses produced by one species can be infective in another, but this is the limit of my understanding. Bizarre world, virology. In any case, they are so tiny, they are usually detected by indirect means. That said, I find it interesting that body pH is related to infectivity.

You took that phrase “J – curve” right out of my mouth! Precisely – everything that is necessary at low concentrations, must follow a J curve, because at high enough levels it must also be poisonous! Thus the quest for ever lower blood cholesterol levels, and ever lower salt levels, simply has to be wrong – just by sheer logic.

AH notepad
You are right about information overload. This chapter 41 already has 390+ comments, whereas the othe day I looked back at the chapter on Potassium which had only 139 comments. How Dr K manages I dont know

SUPPLEMENTS, we have talked a lot about diet on a personal level but skipped around supp’s. I would be interested to know what supps everyone takes, why they take them and if they have registered any meaningful effect. Happy to start

Life extension Multi Vit – taken mainly for the B vits as I have found that just one rather than the supposed two a day keeps my Homocysteine at around 8 when it was once alerted at 21!!

A 1000 iu Vit D3 and K2, I spend a lot of time in the sun so dont need too much of this. I originally took 5000iu and my Vit D went to 121 which is much higher than it needs to be

In the summer I come off the D3 and just take K2 tab, no measurements on benefits on this just trust

I was taking Krill Oil but have just switched to Life extension super Omega 3 tabs. I was impressed by Dr Davies work and my protocol only needed tweaking to come into line.

Sea Kelp, My Iodine levels are OK except my T3 is just below minimum, Only been doing these for a month so too early to remeasure.

Niacin full flush 50mg, not too hung up on LDL but it does tip mine below 3.0mmol also Davies reckons it helps keep LDL size low, I dont currntly have a problem with this.

I tend to flirt between Aged Garlic 600 and Fruitflow tabs. At the moment Garlic as I am slightly more impressed by the backlog of research.

I have tried L Arganine which I can vouch is great for all the things it is reported to do but after a couple of days my stomach gos crazy so unable to keep with it.

It is possible to know if they are effecting benefit, let me give you a couple of examples

When I take B12 and Folate my Homocysteine is below 10, if I dont it creeps up to at least 15, I have tested both.

A couple of years ago I testd my Lp(a) it was 31 which is a bit above what it should be. Now Vit C has been touted as a means to lower Lp(a). I took 1000mg daily and sure enough it lowered to 21. Now while away on a long break abroad I happened to run out and so did not supplement for 6 weeks. On my return I tested and it was back at 30. It has since returned to 21 and now 19 given that I have a daily grapeftuit in the morning as well

A H Notepad, wrote “asprin is a toxin, not a supplement. Taking it is unlikely to be beneficial in the long term.”

I can’t really see the distinction here. Many supplements – such as selenium – are definitely poisonous if taken at higher doses! Something can be beneficial at low concentrations and dangerous at high ones.

I know aspirin causes bleeds in a few people, but practically everything has side effects.

smartersig, I am glad you have stopped taking krill oil. It is another example of the arrogance of the human race in thinking that any species on the planet is fair game for use in supplying an unnecessary fix for the reckless indulgances of modern living.

It was meant as a joke, nothing more. What impact does it have on my ability to conduct a mature discussion, none whats so ever. Other credible members have on the odd occasion interjected with a bit of light hearted humour which I have to say I have enjoyed. Some were funny some less so perhaps like mine but they occasionally break the mood which is good.

A H Notepad, surely Smartersig is entitled here to express his wry sense of humour ?

s for krill they are a species of shrimp adapted to a very ccld water sea environment. And shrimp have been a traditional food source for millennia. You are entitles to not eat eat shrimp or krill if such is your belief.

but Dr Kendrick’s site does not exist to provide a platform for such a view. Or indeed for the opposite paleo view either.

far better that we stick to the issue which is the focus : what causes CVD ?

Krill are a recent example of a species harvested by the ship load to feed a market purporting to be beneficial for humans. A species which has demonstrated it is nearly unable to look after itself, and it is the sickest species on the planet. Perhaps it would be better to leave the krill for those species which do not have an alternative food supply.

I have been watching this interesting blog about 3 months now. I just wanted to comment after seeing the cardiologist at last after 4 months has passed since my MI. The cause of my heart attack was furred up arteries due to smoking (10 a day for 25 years and 5 a day for 10 years) also high cholesterol (which i dont have but its obviously to high for me).
Stress has nothing to do with it, exercise doesn’t make any difference nor does diet.

Supplements like co q10, vitamins, etc have not been proven.

The best thing i can do is keep taking the 8 tablets a day as statins can increase my life by 40% and there is only 3% of people who have side effects out of the millions that take them.
(what about lowering cholesterol that my brain needs, again unproven).

So my heart is only firing at 25% and he wants to fit a gadget because my heart rythm could encouter problems and i could collapse at any moment.( i was to polite to tell where he could stick it, Unbelievable

I am not a medical doctor, but I think I can definitely say you should stop the cigarettes! I understand that can be difficult, but since I never started, I can’t talk from experience!

I was given a statin for purely preventative reasons, but 3 years in, it caused me a lot of problems. I would say that if you continue with the statin, watch out for unexplained joint pains or cramps – or indeed loss of memory. After giving up my statin, I bumped into a remarkable number of people who had encountered similar problems.

I have not touched a cigarette since my event.
I would like to give up the drugs but its hard to have the bottle to do so when only half the heart is
working and you feel like you have been beaten wiith a large stick by the cardiologist.

I dont consider my cholesterol level high it was 5.5 when i got checked at the well man clinic before i was 50. I was told it must be too high for me and thats why my artery was blocked. Im just disappointed that the cardiologist wasn’t as knowledgeable as dr kendrick.

Question for Mart; what was your TG:HDL ratio. Apparently the higher the ratio the more small dense LDL particles are generated. There are some that still believe that small dense LDL is involved in plaque progression. This might happen even if you do not believe.

Mrtin Back: Thanks for the list. I’ve written them down. Impossible to take BP properly in my doctor’s office. One must sit on the exam table with feet and arm dangling. This is part of the reason I pay little attention to the result.

BP, another of those figures used as an excuse to trigger treatment, frequently without understanding the reason for the result. The poor old system is trying to do a complex maintenance job, and along comes matey with a sphygmo, and claims to know better, and the figure should be something else. For example, do they bother to find out how much fluids are consumed each day, and what were they?

SS, Supplements is a huge area. I take a lot of things cycling on and off as you do with D3, I also gravitate to Life extension products.

I take a reduced level of multi vitamin (4 per day instead of 8) and cycle off/on every few weeks to a month. I take Vitamin C 5-8 grams per day on average, then increase if feeling ill at all. I have not had full blown illness in years, I fly 50-75% for my job so Vit C is protection from many environmental factors. Resveratrol, Magnesium, every day, Krill or other oil, pretty much every day.

Other supplements that are 2-3x per week
DHEA, CoQ10, Multi-B, berberine, IP6, K2, D3, Zinc, Astazanthin, E, Potassium when working out or hiking far.

In Europe, start at France, discuss their paradox and work from there.

Or from the US:

“We expected to find geographic variation, but were surprised at how large this variation actually was,” Roth said by email. “Also, we found hotspots for some diseases all over the country, and often high-risk counties are adjacent to very healthy ones. Heart disease and stroke risk appears to vary dramatically almost from one freeway exit to the next.”

But Mark there is no published evidence that it regenerates the thymus.. And regenerating the thymus is how the immune system is regenerated…And so infectious diseases like pneumonia, prevented.

Growth Hormone Effects on Thymus

By far, the most published and predominant observations regarding GH and its interactions with the immune system involve its role in thymus development and function. Earlier observations documented that thymic atrophy was often associated with ablation of the pituitary gland and mice with the dwarf mutation had reduced immune functions [23-24; 26; 32]. Hypophysectomized rats or Snell dwarf mice (dw/dw), which are both defective in the production of GH (and also of prolactin and thyroid hormones) displayed deficiencies in lymphocyte development and function, which were corrected upon administration of exogenous GH to these animals. Similarly, administration of GH was found to enhance the development of the thymus and promote the engraftment of murine or human T cells in SCID mice [23; 26]. Among the most promising immune effects of GH specifically relevant to aging is its potential to improve thymic function, promote thymic and bone marrow engraftment and stimulate hematopoiesis in immunosuppressed and aged animals [23; 26; 32; 56]. Administration of GH or IGF-1 has also been shown to enhance T cell recovery in syngeneic and allogeneic HSCT recipients as well as in aged BMT recipients [23-26; 57-58].

Since fasting has been performed for millennia and has plenty of evidence of multi-benefits behind it, why not just try it? Build up slowly; try a day’s fast once a week for a couple of months, then try two days every so often and build up. I find that after 3 or 4 days is when the magic really begins to happen. Doing a weekly 24 / 36 hour fast and a 3 – 5 day fast two or three times a year is I’m convinced, one of the best things you can do for your health. And it’s free!

Mark I have been doing intermittent fasting for the past year…Along with a range of other things such as HIT workouts at the gym, and a range of supplements.

But the ebidence is that the thymus gland does shrink as we age. And that reduces the immune system’s capacity to deal with infections…It is no accident that the elderly usually die from an infectious disease that in their earlier days was easily fought off..

Hence my comment about Human Growth Hormone. It is availible ( but expensive ) via some doctors with an interest in this field. And for a person who is far advanced with CVD, the option of doing lots of exercise right now, may be unavailable.

By the way I do not recommend getting HGH on the net. It may be cheaper but who nows what is in such stuff.

I am having stents and coils placed in a 7mm basilar tip aneurysm on Thursday. The stents will be there to hold the coils in place as the aneurysm is very wide based. Scared? Yes, I am. Have been on baby aspirin and Plavix pre-op and will have to stay on these for a while post-op. I also have a 237 CAC score, very normal cholesterol levels, normal BP levels, don’t smoke, not overweight and eat a plant based diet but include fish and full fat dairy. I seem to be falling to pieces yet I am not sure why as I don’t tick so many boxes. As for stents, it is the brain, not the heart but, I have no choice but to go with it this time. What I like about this blog, apart from the exceptionally good posts by Dr K, is the discussion that follows. Great work guys and gals.

Yes Linda, good luck for Thursday and I wish you a speedy recovery.
It must be a very stressful time. I’m sure there’s nothing you could have done to prevent this happening – life really does have a habit of throwing curved balls even though we try and do “all the right things”. Lots of good wishes to you.

An average day would see me have for breakfast rolled or steel cut oats cooked in water and topped with full fat Greek yoghurt, cinnamon, banana and blueberries. Lunch is either a huge salad or eggs, mushrooms, tomatoes on whole grain toast or perhaps legumes. Dinner is either salmon and veggies or a veggie meal like eggplant casserole or other seafood, occasionally chicken or lamb. Fresh fruit for dessert. I have one black coffee in the morning with at least three green teas during the day plus lots of water. Last drink of the day is camomile. I drink red wine maybe twice a week. No snacks in the morning but usually have nuts and seeds around three in the afternoon.

Thanks for that detail Linda. May I ask what about other lifestyle features, what do you do for a living. What is your weight/height or BMI and how much/type of exercise do you get ?.
What part of the world are you in (sunshine) and what are the state of your dentures. Sorry to sound probing but they are all possible clues. Oh yes you said I think that your cholesterol was good, what are your Ttoal, HDL and Triglyceride readings… Many thanks

Linda, that seem slike a god diet to me and in fact similar to the one which I currently follow..
But at the risk of boring some folks here, I want to say again that our genetics, our dietary cultural history and our microbiome, all play a hge role in our individual responses to specific foods.

Some blatant examples : I love broad beans ( AKA fava beans in the USA) They are a staple of the diets of nearly all Mediterannean countries… But some poeple in this region are genetically allergic to them and become seriously ill. A second example, the Inuit survived is the extraordinarily harsh arctic for thousands of years by hunting whales and seals With no grain foods at all and no sugar.. But when Canada offered the Inuit Western foods, and the Inuit started consumng bread & sugar and alcohol, they rapidly became very very ill in huge numbers…

The moral of the story is that you are not alone but you will need to work out what works for you and it may be different to everyone else. But there is a mountain of information in Dr K’s posts and yet more mountains in the comments and hypotheses of people here

Smartersig, I am 58kg, 163cm, hdl 1.8, total cholesterol 5.3, trgs .08. I have been in the books/publishing industry all my working life, the last three years editing freelance. I walk 30-60 minutes most days and do yoga practice every day. As for my diet, I am happy with it. I do have treats every now and then too. I am out of hospital, feeling okay and mobile. Get this head of mine in order and get back to living is my objective.

Good to hear that Linda, stay well and keep up the walking for sure.
The original posted asked if I get enough protein, the answer is no, I get too much, pretty much like the rest of the population, but I do get enough fiber

Linda this would concern me
“here has only been one study ever done measuring actual blood flow to the heart muscles of people eating low-carb diets. Dr. Richard Fleming, an accomplished nuclear cardiologist, enrolled 26 people into a comprehensive study of the effects of diet on cardiac function using the latest in nuclear imaging technology–so-called SPECT scans, enabling him to actually directly measure the blood flow within the coronary arteries.

He then put them all on a healthy vegetarian diet, and a year later the scans were repeated. By that time, however, ten of the patients had jumped ship onto the low carb bandwagon. At first I bet he was disappointed, but surely soon realized he had an unparalleled research opportunity dropped into his lap. Here he had extensive imaging of ten people before and after following a low carb diet and 16 following a high carb diet. What would their hearts look like at the end of the year? We can talk about risk factors all we want, but compared to the veg group, did the coronary heart disease of the patients following the Atkins-like diets improve, worsen, or stay the same?

Those sticking to the vegetarian diet showed a reversal of their heart disease as expected. Their partially clogged arteries literally got cleaned out. They had 20% less atherosclerotic plaque in their arteries at the end of the year than at the beginning. What happened to those who abandoned the treatment diet, and switched over to the low-carb diet? Their condition significantly worsened. 40% to 50% more artery clogging at the end of the year.”

I presume you are aware of the information about Dr Richard Fleming, posted by Anthony Sanderson. If you are quoting sources such as this, then you are doing no-one any favours.

Author and former Nebraska physician Richard M. Fleming faces possible sanctions to his medical license following convictions for health care fraud and mail fraud.
Fleming, formerly of the Fleming Heart and Health Institute in Omaha, lives in Reno, Nev.

A cardiologist who has appeared on national news programs, Fleming also garnered state scrutiny in 2004 following leaks from a medical examiner’s report into the death of Dr. Robert Atkins, founder of the famed Atkins’ Diet.
The New York City medical examiner’s office filed a complaint against Fleming after a group with which he was affiliated said Atkins, comatose following a head injury from a fall on the ice, was obese at the time of his death. The examiner’s office then said it erroneously sent Fleming the report.
Fleming is the author of “Stop Inflammation Now!” “The Diet Myth, Keeping Your Heart Forever Young” and “How to Bypass Your Bypass.”
According to complaints filed by Nebraska and Iowa, Fleming was sentenced to five years of probation and six months of electronically monitored home confinement, and he was ordered to pay $107,244 in restitution after pleading guilty in August to one count each of health care fraud and mail fraud.
Fleming admitted that in 2002 he billed Medicare, Medicaid and Blue Cross Blue Shield of Nebraska for falsely represented medical tests.
In 2004, Fleming admitted, he submitted false data after being paid to perform a clinical study on the health benefits of a soy chip food product.
A state licensure hearing regarding his convictions was March 24, said a spokeswoman with the Nebraska Department of Health and Human Services. An order against Fleming’s inactive medical license, if issued, could take as long as six weeks to be announced.
A similar licensure hearing is set in April before the board of medicine in Iowa, where Fleming’s license was active until Feb. 1

I find that one can usually ascertain the motives of others fairly easily. We all have agendas, we all have favoured ideas, they do reveal themselves – usually by what is not said. You might like to try the Dr Kendrick theory of reverse meaning. When someone claims forcibly that they are ‘not’ something, that usually reveals that they are that something As in, when someone says in Parliament ‘with the greatest respect’ they mean the exact opposite. When someone says ‘I am not one to judge.’ they mean, they are. There is another general rule. Ignore everything before the word ‘but.’ Then read Schopenhauer.

Does this mean the research he did with the low carbers is bunkum or does it mean that its an interesting but not conclusive set of outcomes that really ought to spark an interest in finding out more. What I am saying is that if I was a low carber then I would want to run some sort of similar test on myself. I would not throw his claims out of the window simply because he has a tendancy to conduct billing fraud.

That would not mean that I would walk away from this particular study we are discussing. I am finding it hard to find heart disease benefits for Ketogenic long term with the exception of traditional blood markers. Other investigations seem to be negative

It comes down to personal integrity, a quality of varying fashion but of rock solid value admired and admitted by friends and foe respectively. To excuse a liar says something about the observers own value

I would not have taken this piece of evidence at face value anyway as its a small trial but it would make me want to check out further sources. Not sure what my values have to do with it but please take a contrary view to my opinions by all means

My comment is aimed at Researchers who are flexible with the facts, or plain dishonest. That includes their peers who give approval and so encourage bad behaviour.- they are just as lacking integrity as the principal, My apologies to you if it was unclear, trying to be brief and not my wordy self!. I get annoyed with rogue researchers as they taint others, and it would be nice to feel confidence in the honesty of their results. And Keys did some good science, but he’s famous for certain studie full of those pesky flexible facts.

It suggests a significant increase in overall mortality for LCHF and no significant increased risk for death from CVD and incidence of CVD. Interestingly though the risk ratios for CVD are a tad over 1.0 which would possibly add weight to the argument that setting out in life on LCHF is not particularly going to kill you from CVD it is either neutral or at worse so marginally negative that something else is going to get you first. However perhaps in the battle to reverse heart disease (if you accept that this can be achieved) you need some protocol that can improve on neutral.

Smartersig
I havé read the study you have pulled up suggesting LCHF kills you. As a layman I am unable to reach any conclusion as to its veracity etc. I find medical papers are written in a coded jargon, difficult for the uninitiated to understand, moreover anyone trawling the Internet day and night will come up with many papers expressing the contrary point of view. My lipidist, before I fell out with him about statins, said to look for the number of citations and the prestige of the publication. I afterwards realised that this meant that the writer was an accepted member of the club.
I also note you come back often with a sort of message that most of what is written here is wrong. I admire and understand your search for truth, may I respectfully ask you to say what conclusions you have reached in your search.
My own conclusions are keep off medicines that you take for the rest of your puff, exercise, love one another, and eat real food that you can have areasonable chance of knowing what it is and where it came from.

The message from the study is that perhaps LCHF kills you quicker than other diets not kills you per se.
Yes I am constantly probing the various research and opinions and I do not mean to upset people on here but quite frankly I think its essential that a forum such as this has challenges to the concensus after all, are we not all complaining that challenging voices back in 1977 were squashed and we paid a price. My own position to date is that I am not Vegan as some would think but somewhere on a scale between vegan and LCHF. The reason for this is that clearly no one finds an issue with plant based eating or should I say eating plants. There are no Broccolli studies showing increased plaque scores etc. Secondly the overall data surrounding wild fish seems strong so I include fish which I am pleased about because if there are chinks in a purely plant based diet then hopefully this will offset it. With regard carbs, I used to think I was lowish carb but I can see that I am in fact low on simple or high GI carbs but eating lots of veg means I cannot actually be called low carb. On fats I try to eat lots of Mono and some PUFA but with regard to Sat fat I am on the fence a bit. I thought Ornish was fobbing a bit when the new research came out on Sat fat and he said that you need low sat fat to reverse heart disease but having seen that sat fat is at best neutral or maybe just a tad atherogenic it could be that he has a point and for that reason I avoid. Like everybody I am putting my chips down on the table with my best guess, I dont know if I am right on a personal level but its how I see things. Finally I think the main culprits are sugar and refinded carbs and in that sense these battles over plant V meat are probably irrelevant if eaten from natural sources over a lifetime without refined sugars/carbs.

The Richard Fleming study measuring the blood flow rate through the heart piqued my interest. The study, as described on our blog, had plenty of elements that were unsatisfactory. Looking for clarification I think I found the source being quoted.

The study, as described, seems to be be the antithesis of rigorous. The intention to “enrolled 26 people into a comprehensive study of the effects of diet on cardiac function”. . . . and so they chose ONE diet: a “low saturated fat , high carbohydrate diet – a whole foods vegetarian diet–the kind that has been proven to not only stop heart disease, but to in some cases actually reverse it, opening up clogged arteries”. Then after 1 year when the final measurements were due . . . “10 of his patients had, unbeknownst to him, jumped on the low carb bandwagon and begun following the Atkins Diet or Atkins-like diets.” What level of control was there over the diet? What was the Atkins-like diet?

The article claimed that the low sat-fat, whole food vegetarian diet people “got their arteries cleaned out” and blood flow rate through coronary arteries increased by 40%. Whereas . . .”those who abandoned the high carb diet and switched over to the Atkins Diet, chowing down on bunless cheeseburgers? Their condition significantly worsened. All that saturated fat and cholesterol in their diet clogged their arteries further – the blood flow to their hearts was cut 40%.”

The article conclusion . . .
“Thus, the only study on the Atkins Diet to actually measure arterial blood flow showed widespread acceptance of a high saturated fat diet like Atkins could be heralding a future epidemic of fatal heart attacks.”

.
Smartersig . . .
Had a look at the “Low-Carbohydrate Diets and All-Cause Mortality: A Systematic Review and Meta-Analysis of Observational Studies”

First reaction: I groaned at the “meta-analysis of Observational studies” . . . one groan for “meta-analysis” and the second ” observational studies”.

Then I looked at the results, which included . . .
“Of the 272,216 people in 4 cohort studies using the low-carbohydrate score, 15,981 (5.9%) cases of death from all-cause were reported.
The risk of all-cause mortality among those with high low-carbohydrate score was significantly elevated: the pooled RR (95% CI) was 1.31 (1.07–1.59).”
What on earth is a “high low-carbohydrate” diet? I am not sure, but I think they might be talking about high protein/low-carbohydrate score studies mentioned in the text. In which case the results, crudely, seem to say that eating too much protein is bad, marginally.
(I do not think they meant this . . . I think the abstract was badly written)

Wanted to find what the authors had taken as the inclusion criteria for a low-carb diet. I looked but couldn’t find actual figures. As far as I could make out selected papers just had to mention “low carbohydrate” in the title or abstract to be selected.

This from Harvard school of public health offer better news for LCHF but with a proviso for where the fat comes from

“Low carbohydrate diets and heart disease

Research shows that a moderately low-carbohydrate diet can help the heart, as long as protein and fat selections come from healthy sources.

A 20-year prospective study of 82,802 women looked at the relationship between lower carbohydrate diets and heart disease; a subsequent study looked at lower carbohydrate diets and risk of diabetes. Women who ate low-carbohydrate diets that were high in vegetable sources of fat or protein had a 30 percent lower risk of heart disease (4) and about a 20 percent lower risk of type 2 diabetes, (34) compared to women who ate high-carbohydrate, low-fat diets. But women who ate low-carbohydrate diets that were high in animal fats or proteins did not see any such benefits. (4,34)
More evidence of the heart benefits from a lower-carbohydrate approach comes from a randomized trial known as the Optimal Macronutrient Intake Trial for Heart Health (OmniHeart). (35) A healthy diet that replaced some carbohydrate with protein or fat did a better job of lowering blood pressure and “bad” LDL cholesterol than a healthy, higher-carbohydrate diet.
Similarly, the small “EcoAtkins” weight loss trial compared a low-fat, high-carbohydrate vegetarian diet to a low-carbohydrate vegan diet that was high in vegetable protein and fat. While weight loss was similar on the two diets, study subjects who followed the low-carbohydrate “EcoAtkins” diet saw improvements in blood lipids and blood pressure. (36)

Antony High low Carb is the relative risk ratio in other words one to the other, high carb to low carb. Low carbs are therefore riskier.

With regard to the selection they used a percentage of calories obtained from Carbs and Protein arranged in Deciles ie ranked from 0 to 10

Observational studies?, sure not ideal but nothing ever is which ever side of this multi faceted coin we view things from. I have not put these forward as conclusive evidence of anything just the only evidence I can find and sufficient to make me hold back from going down the low carb route.

Steve I am impressed by your careful work on establishing that infectious diseases are a major cause of CVD.

But what about the recent study on a few related families in the Amish ? These famillies have a slightly altered Serpine gene with means that their PAI 1 hormones are reduced. And they have a significantly lower rate of CVD & live on average 10 years longer than other Amish – 83 years !

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354930/
“In general, infectious diseases are more frequent and/or serious in patients with diabetes mellitus, which potentially increases their morbimortality. The greater frequency of infections in diabetic patients is caused by the hyperglycemic environment that favors immune dysfunction (e.g., damage to the neutrophil function, depression of the antioxidant system, and humoral immunity), micro- and macro-angiopathies, neuropathy, decrease in the antibacterial activity of urine, gastrointestinal and urinary dysmotility, and greater number of medical interventions in these patients.”

HI Dr K, I just finished both of your books. Excellent reads! Something hit me when I was reading Cholesterol Con. Women getting CVD later than men…. if they are not protected by hormones until 52ish, could empty nest syndrome be a factor? That is an awful time for a Mum, esp if the kids go far away…. just thinking. I agree with the stress hypothesis. I look forward to your 2018 book and hope you expound on that theory! Shannon

There is also the theory that women are much better at supporting each other emotionally, sharing their feelings rather than bottling them. I think generally this is true. Does it impact the stats, hard to pin down but probably.

For those here interested : Today I saw my GP again after a gap of a month. He tested my BP, on his old fashioned actual column of mercury type device 137/78..

He was pleased ! So was I !

I also showed him the complete list of BP readings since the last consult on the 25th of October, when it was 175/89.

At that consult he stopped the Amlidopine which was making me woosy and having beneficial effect on my BP at all. He then started me on a combi BP medication named Idaprex. A week later it was still fluctuating between 151/81 and 174/90.. So some lowering of BP at times but at other times still quite high & not so good.

It was interesting to see his reaction when I pointed out the progressively lower BP readings after I started the Kyolic garlic capsules. on the 31/10/17. ( I noted this in the readings.) Here are the reading at weekly intervals :
6/11/17 : 154/89
13/11/17 : 140/73
20/11/17 : 136/81..

I continued to take the Idaprex during this time so it has probably also been part of the picture.
However it’s impact in the first week taking it was minimal. And so suspect it was not very useful.

I also gave the GP a printed copy of the Australian research paper someone put a link to here, on garlic & blood pressure with key sections high lighted. His reply was that he does not read research papers. He relies instead on the general consensus of the medical profession as expressed in the published guidelines.

He had no reply to my statement that garlic oil capsules cannot be patented to there in no commercial vested interest to fund research or promote them. Big Pharma is only keen to fund research into drugs that can be patented and so earn a pot of gold.

But I think that he ‘privately’ approves of my course of action. And maybe he will whisper it some other patients ears in future. After all Kyolic garlic capsules ‘work’, at least for me. ( N=1) .

Meanwhile I came away with no need to book another appointment.

And at some point in a week or so I will stop the Idaprex combi and see what happens.

Bill in Oz: By the way, what class of drugs is idaprex? I took as many as three BP drugs at one time: a beta blocker (first to go as it gave me positional hypotension; getting up from squatting in the garden was an adventure in “will I faint completely and break a bone or two?”). Next to go was the diuretic (piss maker), as I learned of its mineral-depleting properties. Finally, the ACE inhibitor, which gave me no apparent adverse effects, and seems to have robust science showing a modest benefit in CVD. I simply wanted a divorce from pharma, and a final decree was granted! Followed by numerous calls and letters from the insurance, none of which I responded to. And I’m not dead yet.

Bill in Oz: Thanks. That was the combo I took, and these two drugs seem to be the only BP drugs with benefits which outweigh the problems they cause. A modest benefit. I got the idea of weaning from “The High Blood Pressure Hoax,” by Sherry A. Rogers, M.D. I found it somewhat annoying to read, but there is lots of good information.

I am getting a little embarrassed by your acknowledgements 🙂 – I am just an “anecdote”.

Still, I believe that it is first when one has carried out an “experiment” on oneself and which has turned out successful that one really gets “converted” and finally also is able to turn the back to Big Pharma and see them for what they are – criminals! Interest for alternatives is the natural outcome.

When the “conversion” is a fact one also start to see how the “criminality” has seeped into the big cash-cows; CVD, diabetes, obesity, blood pressure, vaccinations and cancer. Criminality = When science has been swept under the “greed rug”.

Thanks Goran ! But be not embaressed ! In some ways this is like an old tribal gathering at night around the camp fires.. And then are told the ‘stories’ on what has been done & what has worked and what was foolish and what did not work.. The stories are fixed in everyone’s mind by repetition..

So it needs to be here..I notice newcomers reaching out to join us, seeking help & understanding, in every blog by Dr K.. And so the old timers need to repeat what is known among us…And as for you specifically ? You are the “local hero” on a global blog…

By the way, our Spring has finally warmed up and now it is my time for gardening : sowing pumpkins, planting tomatoes, lettuce, zuchinnis, sweet potatoes. And harvesting strawberries and garlic..I think I will be able to make my own aged garlic oil ! After the hours in the garden today, in the sun and warmth, it felt good to be alive..

Göran, Yes. When my LCHF experiment (n=1) yielded the Nectar of Success… HbA1c down to ‘normal range’ – 5.6, from mid 14’s… 30 kg spare tyre deflated and overall great health..
It was a priceless sense of Achievement, and all without Big Pharma’s Products.